Clinical Application of Electrogastrography in Patients with Stomach Cancer Who Undergo Distal Gastrectomy

PURPOSE: Electrogastrography is a method of measuring action potentials of the stomach. The purpose of this study was to investigate early postoperative changes in the electrogastrography and determine the correlation between electrogastrography and quality of life of patients with stomach cancer who underwent distal gastrectomy. MATERIALS AND METHODS: This study analyzed 20 patients with stomach cancer who underwent electrogastrography and quality of life was measured 1, 12, and 24 weeks after the operation. Quality of life-C30 version 3.0 and quality of life-STO22, were used. RESULTS: Fasting and postprandial mean dominant frequency at 1 week after the operation was 2.7 and 2.7 cycles per minute, and 2.8 and 2.7 cycles per minute at 12 weeks, 2.6 and 2.8 cycles per minute at 24 weeks. Fasting and postprandial mean dominant power at 1 week was 36.5 and 36.4 dB, 36.3 and 40.1 dB at 12 weeks and 40.9 and 42.3 dB at 24 weeks. The percentage of tachygastria was increased whereas the percentage of bradygradia was decreased during the postoperative periods (P0.05). CONCLUSIONS: These may suggest that electrogastrography is a simple and noninvasive method and may be applicated for evaluating motility and autonomic functions of the remnant stomach.

Neuroendocrine Tumor of Unknown Primary Accompanied with Stomach Adenocarcinoma

A 67 year old male at a regular checkup underwent esophagogastroduodenoscopy. On performing esophagogastroduodenoscopy, a lesion about 1.2 cm depressed was noted at the gastric angle. The pathology of the biopsy specimen revealed a well-differentiated adenocarcinoma. On performing an abdominal computed tomography (CT) scan & positron emission tomography-computed tomography (PET-CT) scan, no definite evidence of gastric wall thickening or mass lesion was found. However, lymph node enlargement was found in the left gastric and prepancreatic spaces. This patient underwent laparoscopic assisted distal gastrectomy and D2 lymph node dissection. On final examination, it was found out that the tumor had invaded the mucosal layer. The lymph node was a metastasized large cell neuroendocrine carcinoma with an unknown primary site. The patient refused chemotherapy. He opted to undergo a close follow-up. At the postoperative month 27, he had a focal hypermetabolic lesion in the left lobe of the liver that suggested metastasis on PET-CT scan. He refused to undergo an operation. He underwent a radiofrequency ablation.

Cardiovascular Risk Assessment of Atherosclerotic Arterial Occlusive Diseases

PURPOSE: Cardiovascular risk assessment of atherosclerotic arterial occlusive diseases is a critical component of preoperative care. Many indexes have been developed to help identify patients at high risk for perioperative cardiac events. We sought to study guideline implementation and clinical outcomes in cardiovascular risk assessment. METHOD: We studied 75 patients who underwent preoperative cardiac risk assessment between 2003 and 2006 at the Kyung Hee University Medical Center. The American College of Cardiology/American Heart Association (ACC/AHA) guidelines were used to stratify the patients. RESULT: The mean age of patients was 67.9 years. When stratified into risk categories according to the ACC/AHA guidelines, 2 patients was high risk group, 51 intermediate risk group, and 22 low risk group. There were 3 perioperative cardiac complications (4.0%) including 2 mortalities (2.7%). There was a trend toward a higher frequency of cardiac complications when there was discordance with the ACC/AHA guidelines, but there was no significant difference (discordance 7.1%, concordance 0%, P=0.251). The guidelines recommended cardiac testing for 44 patients, but 12 patients (27.3%) were tested. The guidelines did not recommend for 31 patients, but additional cardiac tests were done for 10 patients (32.3%) and mainly associated with low risk group. CONCLUSION: Differences between clinician practice and guideline recommendations existed and did not result in a higher frequency of cardiac complications.

Incidence of Anti - Ro Antibodies in Patients with Systemic Lupus Crythematosus / 대한피부과학회지

We examined the incidence of anti-Ro antibodies with sera from 60 Korean patients with systemic lupus erythematosus(SLE) by double immunodiffusion. Among these 60 sera tested, 31(51.7%) showed evident immunoprecipitations against Ro antigen on the Ouchterlony plates. Several recent studies indieate that the anti-Ro antibody occurs much less frequently in Occidental lupus patients(around 30%) than in Japanese lupus patients (50%). These data may be suggestive that the racial or ethnic baekground might be an important factor determining the serological, and perhaps the clinical features of SLE.