정순섭 교수

Purpose: Transversus abdominis plane (TAP) block is a newly developed and effective peripheral block involving the nerves of the anterior abdominal wall for lower abdominal surgery. We evaluated the postoperative analgesic efficacy of ultrasoundguided TAP block using 20 mL of 0.5% levobupivacaine in patients undergoing open appendectomy. Methods: Forty-four patients undergoing appendectomy were assigned either to undergo a right sided-TAP block (group I, n = 22), or to receive standard care (gro

Purpose: In recent years, many psychological problems in patients with stomas have been addressed in a number of studies. But there are only a few studies that use objective measures to take into account self-appraisal by patients with permanent or temporary stomas. The aim of this study is to compare the psychological attitude of patients with permanent and temporary stomas and to determine the most appropriate psychological supportive care. Methods: Sixty-five patients, who received a stoma be

Purpose: This study aims to assess the diagnostic efficacy of the Alvarado score and to determine cut-off values of Alvarado score according to age for deciding on the options for patients with suspected appendicitis. Methods: From October 2008 to January 2009, we prospectively reviewed 152 patients with suspected appendicitis. The patients were classified into adults and children groups. We then determined cut-off values of the Alvarado score by analyzing each score’s sensitivity and specificit

A 63-year-old woman was referred to a breast surgeon with a breast mass discovered incidentally during follow-up study after colon cancer surgery. Invasive adenocarcinoma was revealed on core needle biopsy. Wide excision of the breast including the tumor was performed. On standard histological examination the tumor showed features of moderately differentiated adenocarcinoma. The immunohistochemistry study revealed positive results for cytokeratin (CK)20 and CDX2, but negative for CK7. These are

Purpose: The assurance of a negative resection margin is significant in rectal cancer as it indicates a reduced risk of local recurrence; thus, sufficient length of the resection margin is strongly required. The purpose of this study was to analyze the relationship between the length of the distal resection margin (DRM) and local recurrence or survival rate and to evaluate the possibility of performing sphincter-conserving surgery. Methods: The medical records of 218 rectal cancer patients were

최근 발표된 만성 기능성 변비의 진단과 치료 임상 진료지침 개정안은 2011년 발표된 진료지침과는 달리, 다학제 참여를 통해 전문성을 높였고, 진단에 관한 진료지침을 추가하였으며, 새로운 약제를 추가하고 최근 연구 결과에 근거하여권고 등급을 적절하게 변경하였다. 진단 및 치료 방법의 여러 대안을 제시하고, 장ㆍ단점을 요약하며, 약제를 포함하는치료 방법의 선택 기준, 각 치료 방법이 선호되는 임상 상황및 주의사항 등을 포함하는 구체적인 지침을 제시하고자 하였다. 이를 통해 1차 의료기관의 개원의 및 2, 3차 의료기관의 봉직의뿐만 아니라 소화기내과, 소화기외과 및 영상의학과 등 다양한 의료 분야에서 적정 진료를 위한 의사 결정에도움을 주고, 전공의 및 병원 근무 인력에 대해서도 진료 원칙의 길잡이 역할을 하며 교육 자료로도 활용되도록 하였다. 또한 환자에게는 제공받는 서비스의 예측성을 높이고 정보에 입각한 선택을 하도록 도움을 줄 수 있으며, 환자에 대한교육 및 의사 소통 자료로도 활

Purpose: Crohn's disease is a chronic inflammatory disease that despite the advances in medical therapy is difficult to treat requiring surgery in a large proportion of patients as a result of complications. The aim of this study was to assess the clinical features of Crohn's disease patients who underwent one or more surgical interventions during a ten-year period and to establish the indications and surgical procedures in this group of patients. Methods: The medical records of 22 patients with

Purpose: Chest computed tomography is performed frequently for the preoperative pulmonary staging in colorectal cancers (CRCs) regardless of the result of chest x-ray (CXR) due to its high sensitivities and specificities. The advancement of CT technology detects more indeterminate lung lesions that may require further investigations, referrals and follow-up. The aim of this study was to suggest a guideline for performing chest CT for preoperative pulmonary staging in colorectal cancer. Methods:

Purpose: This study is to introduce our preliminary experience of the Doppler-guided hemorrhoidal artery ligation and Rectoanal repair (DG-HAL & RAR) as a new treatment for symptomatic or prolapsed hemorrhoids.Methods: A Doppler probe incorporated proctoscope was inserted under the lithotomy position and the location of the hemorrhoidal artery was identified. The identified artery was ligated as a ‘figure of eight’ method with an absorbable suture into the submucosa. Then the prolapsed hemorrhoi

Purpose: It is controversial to treat complicated appendicitis in pediatric patients on several points, especially optimal time for appendectomy. The purpose of this study is to determine optimal time for operation in perforated appendicitis in pediatric patients. Methods: Children with perforated appendicitis under the age of 14 underwent appendectomy between January 2006 and December 2008 at Ewha Womans University Mokdong Hospital were analyzed retrospectively according to factors which may af

Purpose: It is controversial to treat complicated appendicitis in pediatric patients on several points, especially optimal time for appendectomy. The purpose of this study is to determine optimal time for operation in perforated appendicitis in pediatric patients. Methods: Children with perforated appendicitis under the age of 14 underwent appendectomy between January 2006 and December 2008 at Ewha Womans University Mokdong Hospital were analyzed retrospectively according to factors which may af

Purpose: Early colorectal cancer is defined as invasive tumor, limited to the mucosa or submucosa. The incidence of early colorectal cancer detection has been increased due to well designed screening technology and development of colonoscopy. The novel treatment of early colorectal cancer is still not settled despite of this advancement. We performed retrospective study about outcomes of colorectal cancer after radical resection or local resection. Methods: Sixty two patients, diagnosed as early

Purpose: The screening test for colorectal polyp is important for the early detection and prevention of colorectal cancer. The aims of this study were to evaluate the characteristic findings and the anatomical distribution of colorectal polyps observed during colonoscopy and to determine proper screening candidates to undergo colonoscopy for colorectal cancer. Methods: From March 1999 to February 2004, 3,454 asymptomatic individuals underwent total colonoscopy. The number, the location, and the

Purpose: Genetic susceptibility for colorectal cancer is explained by polymorphisms of the drug-metabolizing enzymes. CYP2E1 activate the procarcinogens and they are involved in carcinogenesis. We analyzed the polymorphisms of CYP2E1 in colorectal cancer patients and the controls, and we examined the interaction between meat intake, smoking and CYP2E1 polymorphisms in colorectal cancer. Methods: Polymerase chain reaction was performed for 96- bp insertion polymorphisms in 113 colorectal cancer p