• Journal of Gastric Cancer
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• 제24권3호
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• pp.341-352
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• 2024

Purpose: Textbook outcome is a comprehensive measure used to assess surgical quality and is increasingly being recognized as a valuable evaluation tool. Delta-shaped anastomosis (DA), an intracorporeal gastroduodenostomy, is a viable option for minimally invasive distal gastrectomy in patients with gastric cancer. This study aims to evaluate the surgical outcomes and calculate the textbook outcome of DA. Materials and Methods: In this retrospective study, the records of 4,902 patients who underwent minimally invasive distal gastrectomy for DA between 2009 and 2020 were reviewed. The data were categorized into three phases to analyze the trends over time. Surgical outcomes, including the operation time, length of post-operative hospital stay, and complication rates, were assessed, and the textbook outcome was calculated. Results: Among 4,505 patients, the textbook outcome is achieved in 3,736 (82.9%). Post-operative complications affect the textbook outcome the most significantly (91.9%). The highest textbook outcome is achieved in phase 2 (85.0%), which surpasses the rates of in phase 1 (81.7%) and phase 3 (82.3%). The post-operative complication rate within 30 d after surgery is 8.7%, and the rate of major complications exceeding the Clavien-Dindo classification grade 3 is 2.4%. Conclusions: Based on the outcomes of a large dataset, DA can be considered safe and feasible for gastric cancer.

• 정보처리학회논문지:소프트웨어 및 데이터공학
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• 제9권3호
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• pp.101-108
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• 2020

최근의 영상 처리 분야는 딥러닝 기법들의 성능이 입증됨에 따라 다양한 분야에서 이와 같은 기법들을 활용해 영상에 대한 분류, 분석, 검출 등을 수행하려는 시도가 활발하다. 그중에서도 의료 진단 보조 역할을 할 수 있는 의료 영상 분석 소프트웨어에 대한 기대가 증가하고 있는데, 본 연구에서는 데이터 셋이 방대하고 판단에 시간이 오래 걸리는 캡슐내시경 영상에 주목하였다. 본 논문의 목적은 캡슐내시경 영상의 판독에서 모든 환자에 대해 공통으로 수행되고, 판독하는 데 많은 시간을 차지하는 위장관 랜드마크를 구별하고 위장관 교차점을 추정하는 것이다. 이를 위해, 위장관 랜드마크를 식별할 수 있는 CNN 학습 모델을 설계하였으며, 이를 이용하여 결괏값을 필터링해 위장관 교차점을 추정하였다. 무작위로 환자 데이터를 샘플링한 모델을 이용해서 나온 결과를 필터링 후에 위장관 교차점을 추정하였을 때, 88% 환자는 위장에서 소장으로 변화하는 위장관 교차점(유문판) 의심 구역 안에 들어왔으며, 소장에서 대장으로 변화하는 위장관 교차점(회맹판)의 경우 100% 환자가 위장관 교차점 의심 구역 안에 들어온 것을 확인할 수 있었다. 100프레임 범위로 위장관 교차점 의심 구역을 찾을 수 있었으며, 판독자가 초당 10프레임의 속도로 판독을 진행한다면 10초안에 위장관 교차점을 찾아낼 수 있다.

• 대한한방소아과학회지
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• 제22권2호
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• pp.217-225
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• 2008

Objectives : Prevalence of night eating habit associated with substance use and obesity is increasing rapidly in children and adolescents. Further, staying up late and eating snacks late at night were known as leading health risk behaviors for children, suggesting the potential adverse effect of night-eating habit on children. However, only few reports had been issued on the effect of night-eating habit on gastrointestinal symptom and SUI-TAI(水滯) symptom of children. Therefore, we aimed to investigate clinical characteristics of children by night-eating symptom status. Methods : Parents were asked to give a detailed answer to a systemized medical history questionnaire concerning night-eating habit, gastrointestinal symptom and SUI-TAI symptom of their children. Medical records of 28 children treated in the Department of Pediatrics, Hospital of Oriental Medicine, were the subject of this study. Clinical characteristics of two groups of children who with no night-eating habit and frequent night-eating group(eating at night more than 3 times per week) were analysed. In addition, the correlation analysis between clinical characteristics were performed. Results : Children with frequent night-eating habit(n=7, more than 3 days of night-eating a week) were observed to have more aggravated gastrointestinal symptom and SUI-TAI symptom compared with those without night-eating habit(n=13). In parallel, the association of gastrointestinal symptom and SUI-TAI symptom was demonstrated(n=28). Conclusions : It is notable that deranged gastrointestinal function and aggravated SUI-TAI symptom were observed among children generally regarded as healthy. Therefore, endeavors to correct night-eating habit as well as to treat aggravated gastrointestinal and SUI-TAI symptoms are needed for the promotion of health of children.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제17권1호
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• pp.23-30
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• 2014

Manometry is a noninvasive diagnostic tool for identifying motility dysfunction of the gastrointestinal tract. Despite the great technical advances in monitoring motility, performance of the study in pediatric patients has several limitations that should be considered during the procedure and interpretation of the test results. This article reviews the clinical applications of conventional esophageal and anorectal manometries in children by describing a technique for performing the test. This review will develop the uniformity required for the methods of performance, the parameters for measurement, and interpretation of test results that could be applied in pediatric clinical practice.

• Journal of Medicine and Life Science
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• 제21권2호
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• pp.49-52
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• 2024

Massive gastric mucosal ruptures during upper gastrointestinal endoscopy in patients with esophageal hiatal hernias are rare. However, tearing of the gastric mucosa alone, without tearing of the gastroesophageal junction, is even rarer. This study reports a case of a large mucosal rupture that occurred on the posterior wall of the upper body of the stomach during upper gastrointestinal endoscopy in an 83-year-old woman with an esophageal hiatal hernia while sedated. The patient was treated with endoclips for the rupture.

• 대한수의학회지
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• 제41권2호
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• pp.123-132
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• 2001

ICR 마우스 위장관 8개 부위(위저부, 유문부, 십이지장, 공장, 회장, 맹장, 결장 및 직장)에서 위장관내분비 세포의 부위별 분포 및 상대적 빈도를 somatostain, serotonin, glucagon, chloecystokinin(CCK)-8, secretin, pancreatic polypeptide(PP) 및 gastrin 등 총 7종류의 항혈청을 이용한 면역조직화학적 방법으로 관찰하였던 결과 somatostain, serotonin, glucagon, CCK-8, secretin, 및 gastrin 면역반응세포의 7종류의 내분비세포가 관찰되었다. 본 실험의 결과 장관부위에서는 주로 타원형 또는 방추형의 개방형 세포(open-typed cell)들이 관찰된 반면 위저부와 유문부에서는 주로 원형의 폐쇄형 세포(close-typed cell)을이 관찰되었다. 이들 면역반응세포들의 부위별 분포는 위장관 각 부위에 따라 매우 다양하게 관찰되었다. Somatostain 면역반응세포들은 대장을 제외한 위장관에서 전 부위에서 관찰되었고, serotonin 면역반응세포들은 전 위장관에 걸쳐 관찰되었으며, ICR 마우스에서 가장 높은 빈도를 나타내었다. Glucagon 면역반응세포들은 위저부와 직장에 국한되어 관찰되었으며, 각각 중등도 및 소수의 빈도를 나타내었다. CCK-8 면역반응세포들은 유문부, 십이지장 및 회장에서 각각 다수, 중등도 및 극소수의 빈도로 관찰되었다. 한편 secretin 면역반응세포들은 각각 소수 및 극소수의 빈도로 십이지장과 회장에 국한되어 출현하였고, gastrin 면역반응세포들은 유문부에 국한되어 다수 관찰되었다. 그러나 PP 면역반응세포들은 전 위장관에 걸쳐 관찰되지 않았다. 결론적으로 ICR 마우스의 위장관내분비세포의 부위별 분포 및 상대적 빈도는 다른 포유동물과 유사하게 관찰되었으나, 일부 특이한 양상을 나타내기도 하였다.

• Biomolecules & Therapeutics
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• 제19권1호
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• pp.84-89
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• 2011

The present study was undertaken to determine whether combined treatment with prokinetic trimebutine and mosapride has a synergic effect on gastrointestinal motility and visceral pain associated with gastrointestinal dysfunction. To develop effective gastroprokinetic agents with greater potencies than trimebutine or mosapride for the treatment of gastrointestinal tract disease, a mixture of trimebutine and mosapride was designed and prepared. In the present study, treatment with trimebutine alone showed a dose-dependent effect on propelling movements of normal small and large intestine in mice, whereas mosapride effected only small intestine motility. Co-administration of trimebutine with mosapride, a well-established prokinetic drug, produced a synergistic influence on normal small intestine motility, but demonstrated an unclear effect on large intestine motility, with a slight tendency to reduce the propelling time. In a stress model, the small and large intestine motilities were significantly decreased. The reduction of intestine motility was restored to a normal level and the restoring effect was more pronounced in the combined treatment with trimebutine plus mosapride than treatment with trimebutine or mosapride alone. Furthermore, treatment with trimebutine plus mosapride significantly decreased acute visceral pain which was not controlled by trimebutine or mosapride alone. These data suggest that combination therapy with trimebutine plus mosapride has a synergic effect on small and large intestine motility and visceral pain control in gastrointestinal disorders.

• Journal of Gastric Cancer
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• 제15권2호
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• pp.113-120
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• 2015

Purpose: Although several clinical trials have proven the efficacy of adjuvant S-1 treatment in gastric cancers, it is still unclear which patients receive the most benefit. In this study, we prospectively recruited patients with locally advanced gastric cancer who had undergone curative resection followed by adjuvant S-1 administration to investigate which factors affect the outcomes. Materials and Methods: Between July 2010 and October 2011, we enrolled 49 patients who underwent curative resection for stage II or III gastric cancer and who subsequently received adjuvant S-1 treatment for 1 year. Results: Twenty-nine patients (59.2%) continued S-1 treatment for 1 year, and 12 patients (24.5%) experienced recurrent disease during the follow-up period. Patients with continuation of S-1 for 1 year had significantly increased rates of disease-free survival (P<0.001) and overall survival (P=0.001) relative to the patients who discontinued S-1 during year 1. Multivariate analysis indicated poor outcomes for patients with stage III disease and those who discontinued S-1 treatment. Excluding patients who discontinued S-1 due to cancer progression (n=7), adjuvant treatment with S-1 still demonstrated a significant difference in the disease-free survival rate between the patients who continued treatment and those who discontinued it (P=0.020). Conclusions: S-1 is tolerated as adjuvant treatment in gastric cancer patients. However, discontinuing S-1 treatment may be an unfavorable factor in the prevention of recurrence. S-1 adjuvant treatment should be continued for 1 year if possible through the proper management of toxicities.

• 대한수의학회지
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• 제40권2호
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• pp.237-245
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• 2000

한국재래산양의 개체발생의 단계별 (1일령, 1개월령, 6개월령, 성체) 차이에 따른 위장관에 존재하는 somatostatin 면역반응세포의 부위벌 분포와 출현빈도률 알아보기 위하여 면역조직화학적 방법으로 관찰하였던 바, somatostatin 면역반응세포는 모든 실험군의 전 위장관에 분포하였으며, 위저부에서 가장 다수로 관찰되었으며, 각 실험군에서 소화관의 원위부로 갈수록 또 연령이 중가할수록 이들 세포는 감소하는 것으로 관찰되었다. 또한 이들 세포들의 형태는 유문부에서 주로 구형, 타원형, 난원형의 폐쇄형 세포가 주로 관찰되었으며, 장 부위에서는 방추형의 개방형 세포가 다수 관찰되었다. 이들 면역반응세포의 각 연령에서외의 정확한 의의는 알 수 없으나 분포 및 빈도의 차이는 연령에 따른 식이습성과 생리적 변화에 기인한 것으로 생각된다.

• Journal of Gastric Cancer
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• 제21권3호
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• pp.308-318
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• 2021

Purpose: The benefits of robotic gastrectomy remain controversial. We designed this study to elucidate the advantages of a hybrid robot and laparoscopic gastrectomy over conventional laparoscopic surgery. Materials and Methods: A total of 176 patients who underwent gastrectomy for gastric cancer were included in this study. We compared 88 patients treated with hybrid robotic and laparoscopic gastrectomy (HRLG) and 88 patients who underwent conventional laparoscopic gastrectomy (CLG). In HRLG, suprapancreatic lymph node (LN) dissection was performed in a robotic setting. Clinicopathological characteristics, operative details, and short-term outcomes were analyzed for the patients. Results: The number of LNs retrieved from the suprapancreatic area was significantly greater in the HRLG group (11.27±5.46 vs. 9.17±5.19, P=0.010). C-reactive protein levels were greater in the CLG group on both postoperative day (POD) 1 (5.11±2.64 vs. 4.29±2.38, P=0.030) and POD 5 (9.86±6.51 vs. 7.75±5.17, P=0.019). In addition, the neutrophil-to-lymphocyte ratio was significantly greater in the CLG group on both POD 1 (7.44±4.72 vs. 6.16±2.91, P=0.031) and POD 5 (4.87±3.75 vs. 3.81±1.87, P=0.020). Pulmonary complications occurred only in the CLG group (4/88 [4.5%] vs. 0/88 [0%], P=0.043). Conclusions: HRLG is superior to CLG in terms of suprapancreatic LN dissection and postoperative inflammatory response.