检索结果-南通市图书馆

Experience of primary intestinal lymphangiectasia in adults: Twelve case series from a tertiary referral hospital

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Clinical Cases 2024年第4期12卷 746-757页

作者： Ji Eun Na Ji Eun Kim Sujin Park Eun Ran Kim Sung Noh Hong Young-Ho Kim Dong Kyung Chang Department of internal medicine Inje University Haeundae Paik HospitalBusan 48108South Korea Department of medicine Samsung Medical CenterSeoul 06351South Korea Department of Pathology Samsung Medical CenterSeoul 06351South Korea

BACKGROUND While primary intestinal lymphangiectasia(PIL)is considered a rare condition,there have been several reported cases in adults.Nevertheless,the absence of clear guidance from diagnosis to treatment and prognosis poses challenges for both physicians and patients.AIM To enhance understanding by investigating clinical presentation,diagnosis,treatment,complications,and prognoses in adult PIL cases.METHODS We enrolled adult patients diagnosed with PIL between March 2016 and September 2021.The primary outcome involved examining the diagnosis and treatment process of these patients.The secondary outcomes included identifying complications(infections,thromboembolism)and assessing prognoses(frequency of hospitalization and mortality)during the follow-up period.RESULTS Among the 12 included patients,peripheral edema(100%)and diarrhea(75%)were the main presenting complaints.Laboratory tests showed that all the pati-ents exhibited symptoms of hypoalbuminemia and hypogammaglobulinemia.Radiologically,the predominant findings were edema of the small intestine(67%)and ascites(58%).The typical endoscopic finding with a snowflake appearance was observed in 75%of patients.Among the 12 patients,two responded positive-ly to octreotide and sirolimus,and eight who could undergo maintenance therapy discontinued subsequently.Complications due to PIL led to infection in half of the patients,thromboembolism in three patients,and one death.CONCLUSION PIL can be diagnosed in adults across various age groups,with different severity and treatment responses among patients,leading to diverse complications and prognoses.Consequently,tailored treatments will be necessary.We anticipate that our findings will contribute to the management of PIL,an etiology of protein-losing enteropathy.

关键词： Primary intestinal lymphangiectasia in adults Protein-losing enteropathy Diagnosis Treatment Prognosis

Prospective comparison of prophylactic antibiotic use between intravenous moxifloxacin and ceftriaxone for high-risk patients with post-ERCP cholangitis

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Hepatobiliary & Pancreatic Diseases International 2017年第5期16卷 512-518页

作者： Nam Hee Kim Hong Joo Kim Ki Bae Bang Department of internal medicine Sungkyunkwan University Kangbuk Samsung Hospital Department of internal medicine Dankook University Hospital

BACKGROUND: The use of prophylactic antibiotics before endoscopic retrograde cholangiopancreatography(ERCP) is recommended by all major international gastroenterological societies, especially in the presence of an obstructed biliary system. This study compared the occurrence rate of post-procedural complications, including cholangitis and septicemia between prophylactic intravenous moxifloxacin and ceftriaxone in patients with bile duct obstruction scheduled for therapeutic ERCP.METHODS: From November 2013 to July 2015, 86 consecutive patients with biliary obstruction with one or more factors predicting benefits of antibiotic prophylaxis prior to ERCP were included in the current randomized open-label non-inferiority trial(Clinical Trial.gov identifier NCT02098486). Intravenous moxifloxacin(400 mg/day) or ceftriaxone(2 g/day)were given 90 minutes before ERCP, and were administered for more than 3 days if the patient developed symptoms and signs of cholangitis or septicemia. Recalcitrant cholangitis was defined as persistence of cholangitis for more than 5 days after ERCP or recurrence of cholangitis within 30 days after ERCP.RESULTS: Recalcitrant cholangitis occurred in 1(2.3%) and 2(4.8%) patients receiving intravenous moxifloxacin and ceftriaxone group, respectively(P=0.612). Septicemia was noted in1(2.3%) and 1(2.4%) patient in intravenous moxifloxacin and ceftriaxone group, respectively(P=1.0). The mean hospital stay was also not significantly different between the moxifloxacin and ceftriaxone groups(8.8±7.2 vs 9.1±9.4 days, P=0.867). Antibiotic resistance of the isolated pathogens by in vitro activity assay was noted in 1(2.3%) and 2(4.8%) patients in the moxifloxacin and ceftriaxone group, respectively(P=0.612). CONCLUSION: Intravenous moxifloxacin is not inferior to intravenous ceftriaxone for the prophylactic treatment of post-ERCP cholangitis and cholangitis-associated morbidity.

关键词： endoscopic retrograde cholangiopancreatography cholangitis moxifloxacin ceftriaxone recalcitrant cholangitis

Preoperative risk factors for early recurrence in patients with resectable pancreatic ductal adenocarcinoma after curative intent surgical resection

在线全文

学校读者我要写书评

暂无评论

Hepatobiliary & Pancreatic Diseases International 2018年第5期17卷 450-455页

作者： Nam Hee Kim Hong Joo Kim Division of Gastroenterology Department of Internal Medicine Kangbuk Samsung Hospital Sungkyunkwan University School of Medicine

Background: Postoperative early recurrence(ER) in patients with pancreatic ductal adenocarcinoma(PDAC) is frequently encountered after curative intent surgery. Nonetheless, clinical significance and risk factors of ER after surgery for PDAC have not been extensively investigated. The aim of this study was to determine preoperative risk predictors for ER in patients with PDAC after upfront surgery. Methods: Eighty-one consecutive patients with PDAC who underwent curative intent surgical resection at kangbuk samsung hospital between January 2004 and May 2015 were enrolled. ER was defined as tumor relapse within 6 months after surgery. Results: ER occurred in 26 patients(32.1%), whereas 49 patients(60.5%) had late recurrence( ≥ 6 months after surgery), and 6 patients had no recurrence(7.4%). Univariate analysis showed that C-reactive protein(CRP) > 3.0 mg/dL, modified Glasgow prognostic score(mGPS) = 2, decrease of total lymphocyte count by > 50% of baseline value in the preoperative period, prognostic nutritional index(PNI) 3.0 mg/dL, decrease of total lymphocyte count by > 50% of baseline value, and preoperative SUVmax were significant and independent contributors of ER in patients with resectable PDAC who underwent curative intent surgery. Conclusions: Postoperative ER for resectable PDAC was frequent with poor prognosis after curative intent upfront surgery. It is reasonable to suggest that there is a subgroup of resectable PDAC patients at highrisk of ER and neoadjuvant therapy should be considered in these patients in a clinical trial setting.

关键词： Early recurrence Pancreatic ductal adenocarcinoma Preoperative risk factors C-reactive protein Maximum standardized uptake value

Arterial stiffness expressed as brachial–ankle pulse wave velocity and gait assessment independent of lower extremity strength:a cross-sectional study in the older men population

在线全文

学校读者我要写书评

暂无评论

Journal of Geriatric Cardiology 2023年第2期20卷 91-99页

作者： Tae Kyung Yoo Seunghee Lee Sae-Jong Park Jong-Young Lee Department of medicine MetroWest Medical CenterFraminghamUSA Department of Physical Education Korea UniversitySeoulSouth Korea Division of Sports Science Korea Institute of Sport ScienceSeoulSouth Korea Division of Cardiology Department of Internal MedicineKangbuk Samsung HospitalSungkyunkwan University School of MedicineSeoulSouth Korea

BACKGROUND Older men are more vulnerable to fatal falls than women,and gait disturbances contribute to the risk of falls.Studies have assessed the association between arterial stiffness and gait dysfunction,but the results have been inconclusive.This study aimed to conduct a cross-sectional analysis to evaluate the association between brachial–ankle pulse wave velocity(baPWV)and gait assessment in older men.METHODS Data from the 2014–2015 Korea Institute of Sport Science Fitness Standards project were used for the analysis.The inclusion criteria were men aged>65 years with gait assessment[the 30-s chair stand test(30s-CST),the timed up and go(TUG)test,the figure-of-8 walk(F8W)test,the 2-min step test(2MST),and the 6-min walk test(6MWT)]and baPWV measurement data.Generalized linear regression analysis was conducted with multiple confounding factor adjustments,including lower extremity isometric strength.RESULTS A total of 291 participants were included in the analysis.The mean age was 71.38±4.40 years.The mean values were as follows:(1)30s-CST,17.48±5.00;(2)TUG test,6.01±1.10 s;(3)F8W test,25.65±4.71 s;(4)2MST,102.40±18.83 per 2 min;and(5)6MWT,500.02±85.65 m.After multivariable adjustment,baPWV was associated with the 6MWT(β=−0.037,95%CI:−0.072–−0.002),TUG test(β=0,95%CI:0.000–0.001),and F8W test(β=0.002,95%CI:0.000–0.004).baPWV was not associated with the 30s-CST and 2MST.CONCLUSIONS The current study showed a statistically significant association between gait assessments and arterial stiffness,independent of lower extremity strength.However,this association was modest.Future prospective studies are needed to elucidate the complex relationship between arterial stiffness and gait dysfunction.

关键词： stiffness sectional pulse

Intraoperative radiofrequency ablation with or without tumorectomy for hepatocellular carcinoma in locations difficult for a percutaneous approach

在线全文

学校读者我要写书评

暂无评论

Hepatobiliary & Pancreatic Diseases International 2009年第6期8卷 591-596页

作者： Hyung Ook Kim Seung Kwon Kim Byung Ho Son Chang Hak Yoo Hyun Pyo Hong Yong Kyun Cho Byung Ik Kim Departments of Surgery kangbuk samsung hospital Sungkyunkwan University School of Medicine Radiology kangbuk samsung hospital Sungkyunkwan University School of Medicine Division of Interventional Radiology Mallinckrodt Institute of RadiologyWashington University School of Medicine internal medicine kangbuk samsung hospital Sungkyunkwan University School of Medicine

BACKGROUND:Although hepatic resection is widely accepted as a proper modality for treating hepatocellular carcinoma(HCC),a majority of patients are unable to undergo surgical resection due to various tumor and patient factors.Radiofrequency ablation(RFA)has mostly been used as a therapeutic alternative to resection for treating HCC.The objective of this study was to evaluate the results of intraoperative RFA for HCCs in locations difficult for a percutaneous approach.METHODS:Eight patients(male,seven;age,49-67 years) with 8 HCCs in difficult locations were treated by intraoperative RFA.Six of the patients had local tumor progression after initial transarterial chemoembolization or ultrasound(US)guided percutaneous RFA.The locations of the tumors were hepatic dome in six patients,posterior subcapsule in one,and caudate lobe in one.The tumor size was 2.0 to 6.4 cm(mean,3.9 cm).Intraoperative RFA was performed at the tumor itself and an anticipated resection line under US guidance with 3 cm monopolar single or clustered internally cooled electrodes.Tumor resection was performed in six patients.One month later,treatment response was assessed by contrast material-enhanced computed tomography(CT).CT studies were performed every 2 or 3 months after RFA.RESULTS:RFA was technically successful in all tumors,and the contrast-enhanced CT images acquired one month later showed complete disappearance of tumor enhancement.One pneumothorax occurred.After a median follow-up of 18 months(range,6-30 months),no tumors showed local progression.During the follow-up period,four new recurrent tumors were observed in three patients.Four patients were alive at the time of this report and the other four died of hepatorenal syndrome,liver failure,and progression of new recurrent tumors.CONCLUSION:Intraoperative RFA with tumor resection can be an alterative treatment option for HCC in locations difficult for a percutaneous approach.

关键词： hepatocellular carcinoma radiofrequency ablation intraoperative

Outcome of laparoscopic cholecystectomy is not influenced by chronological age in the elderly

在线全文

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2009年第6期15卷 722-726页

作者： Hyung Ook Kim Jung Won Yun Jun Ho Shin Sang Il Hwang Yong Kyun Cho Byung Ho Son Chang Hak Yoo Yong Lai Park Hungdai Kim Departments of Surgery Kangbuk Samsung Hospital Sungkyunkwan University School of MedicineSeoul 110-746 South Korea Departments of internal medicine Kangbuk Samsung HospitalSungkyunkwan University School of MedicineSeoul 110-746South Korea

AIM:To evaluate the outcome of laparoscopic cholecystectomy(LC)in patients aged 80 years and older. METHODS:A total of 353 patients aged 65 to 79 years(group 1)and 35 patients aged 80 years and older(group 2)underwent LC.Patients were further classified into two other groups:those with uncomplicated gallbladder disease(group A)or those with complicated gallbladder disease(group B). RESULTS:There were no significant differences between the age groups(groups 1 and 2)with respect to clinical characteristics such as age,gender,comorbid disease,or disease presentation.Mean operative time,conversion rate,and the incidence of major postoperative complications were similar in groups 1 and 2.However,the percentage of high-risk patients was significantly higher in group 2 than in group 1 (20.0%vs 5.7%,Phospital stay(7.9±6.5 d vs 5.0±3.7 d, P<0.01),and the incidence of major postoperative complications(9.8%vs 3.1%,P<0.05)were significantly greater than in group A.The conversion rate tended to be higher in group B,but this difference was not significant. CONCLUSION:Perioperative outcomes in elderly patients who underwent LC seem to be influenced by the severity of gallbladder disease,and not by chronologic age.In octogenarians,LC should be performed at an earlier,uncomplicated stage of the disease whenever possible to improve perioperative outcomes.

关键词：胆囊切除术老年人胆囊炎治疗方法

Infliximab vs adalimumab:Points to consider when selecting antitumor necrosis factor agents in pediatric patients with Crohn’s disease

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2023年第18期29卷 2784-2797页

作者： Eun Sil Kim Ben Kang Department of Pediatrics Kangbuk Samsung HospitalSungkyunkwan University School of MedicineSeoul 03181South Korea Department of Pediatrics School of MedicineKyungpook National UniversityDaegu 41944South Korea

Biologic agents with various mechanisms against Crohn’s disease(CD)have been released and are widely used in clinical practice.However,two anti-tumor necrosis factor(TNF)agents,infliximab(IFX)and adalimumab(ADL),are the only biologic agents approved by the Food and Drug Administration for pediatric CD currently.Therefore,in pediatric CD,the choice of biologic agents should be made more carefully to achieve the therapeutic goal.There are currently no headto-head trials of biologic agents in pediatric or adult CD.There is a lack of accumulated data for pediatric CD,which requires the extrapolation of adult data for the positioning of biologics in pediatric CD.From a pharmacokinetic point of view,IFX is more advantageous than ADL when the inflammatory burden is high,and ADL is expected to be advantageous over IFX in sustaining remission in the maintenance phase.Additionally,we reviewed the safety profile,immunogenicity,preference,and compliance between IFX and ADL and provide practical insights into the choice of anti-TNF therapy in pediatric CD.Careful evaluation of clinical indications and disease behavior is essential when prescribing anti-TNF agents.In addition,factors such as the efficacy of induction and maintenance of remission,safety profile,immunogenicity,patient preference,and compliance play an important role in evaluating and selecting treatment options.

关键词： Anti-tumor necrosis factor Infliximab Adalimumab Crohn’s disease Pediatric

Differential diagnoses of magnetic resonance imaging for suspected acute appendicitis in pregnant patients

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Emergency medicine 2018年第1期9卷 26-32页

作者： Ji Yong Jung Ji Ung Na Sang Kuk Han Pil Cho Choi Jang Hee LEE Dong Hyuk Shin Department of Emergency medicine Kangbuk Samsung Hospital Sungkyunkwan University School of Medicine

BACKGROUND: Accurate and timely diagnosis of acute surgical disease in pregnant patient is chal enging. Although magnetic resonance imaging(MRI) is the most accurate modality to diagnose acute appendicitis in pregnant patients, it is often used as a last resort because of high cost and long scan time. We performed this study to analyze differential diagnoses of appendix MRI and to investigate if there are any blood tests that can predict surgical condition in pregnant patients.METHODS: A retrospective, cross-sectional study was conducted on 46 pregnant patients who underwent non-enhanced appendix MRI in suspicion of acute appendicitis from 2010 to 2016. Differential diagnoses of appendix MRI were analyzed and blood tests were compared between those who had surgical and non-surgical disease.RESULTS: Appendix MRI differentiated two surgical disease; acute appendicitis and ovarian torsion; and various non-surgical conditions such as uterine myoma, hydronephrosis, ureterolithiasis and diverticulitis among clinically suspected acute appendicitis in pregnancy. The diagnostic accuracy of MRI for acute appendicitis in this study was 93.5%. Patients who had surgical disease showed significantly higher WBC count(≥11,000/mm^3), proportion of neutrophils in the WBC(≥79.9%), neutrophil-to-lymphocyte ratio(NLR≥6.4), levels of C-reactive protein(CRP≥1.82 mg/dL) and bilirubin(≥0.66 mg/dL) than those who had non-surgical disease.CONCLUSION: MRI can reliably differentiate surgical conditions and several blood tests(WBC, proportion of neutrophils in the WBC, NLR, CRP, bilirubin) can help anticipate acute surgical condition among pregnant patients suspected to have acute appendicitis.

关键词： Appendicitis Magnetic resonance imaging Pregnancy Neutrophils

Quality of survival in patients treated for malignant biliary obstruction caused by unresectable pancreatic head cancer: surgical versus non-surgical palliation

在线全文

学校读者我要写书评

暂无评论

Hepatobiliary & Pancreatic Diseases International 2008年第6期7卷 643-648页

作者： Hyung Ook Kim Sang Il Hwang Hungdai Kim Jun Ho Shin Department of Surgery Kangbuk Samsung Hospital Sungkyunkwan University School of Medicine

BACKGROUND:Appropriate palliation for unresectable pancreatic head cancer is most important.This study was undertaken to compare the survival of patients with biliary obstruction caused by unresectable pancreatic head cancer after surgical and non-surgical palliation. METHODS:We retrospectively reviewed 69 patients who underwent palliative treatment for unresectable pancreatic head cancer.Fifty-two patients with locally advanced disease (local vascular invasion)and 17 with distant metastatic disease were included.The patients were divided into two groups,surgical and non-surgical palliation. RESULTS:Thirty-eight patients underwent biliary bypass surgery and 31 had percutaneous transhepatic biliary drainage(PTBD).There was no significant difference in the early complications,successful biliary drainage, recurrent jaundice,and 30-day mortality between surgical palliation and PTBD.However,in 52 patients whose tumor was unresectable secondary to local vascular invasion,the rate of recurrent jaundice after successful surgical biliary palliation was lower than that in patients who had non- surgical palliation(Phospital-free survival rate(Phospital stay(P=0.004)during the first admission period.CONCLUSIONS:In patients with preoperative evaluations showing potentially resectable tumors and/or no metastatic lesions,surgical exploration should be performed.Thus,in patients who have unresectable cancer or limited metastatic disease on exploration,surgical palliation should be performed for longer survival and better quality of survival.

关键词： pancreatic cancer obstructive jaundice palliation