As the incidence of early gastric cancer increases, gastric tumor localization has become an important issue. Several diagnostic methods have been proposed for preoperative and intraoperative gastric tumor localization. These include endoscopic metal clipping, computed tomographic gastrography, endoscopic tattooing, and intraoperative endoscopy. However, in spite of various methods, tumor localization has its limitations; thus, new diagnostic alternatives need to be developed.

As the incidence of early gastric cancer increases, gastric tumor localization has become an important issue. Several diagnostic methods have been proposed for preoperative and intraoperative gastric tumor localization. These include endoscopic metal clipping, computed tomographic gastrography, endoscopic tattooing, and intraoperative endoscopy. However, in spite of various methods, tumor localization has its limitations; thus, new diagnostic alternatives need to be developed.

A 69-year old man presented with severe epigastric pain for 1 day. He had early gastric cancer at the antrum and underwent a distal subtotal gastrectomy and Billorth II gastrojejunostomy one month later without any post-operative complications. Radiologic examination revealed a large amount of retroperitoneal free air formation. Because of unremitting pain and unstable vital sign, exploratory laparotomy was followed. During the operation, a perforated duodenal diverticulum at the posterior wall of the 2nd portion of the duodenum was identified. He underwent diverticulectomy and primary closure. He was discharged on the 18th post operative day and has been followed up without any evidence of comlpication for several months.
Aged ; Diverticulum* ; Duodenum ; Gastrectomy* ; Gastric Bypass* ; Humans ; Laparotomy ; Stomach Neoplasms ; Vital Signs

OBJECTIVE: To obtain the mean value of physical parameters of those over 65- years of age. METHODS: Physical parameters including body weight, height, chest circumference, length of upper limb and lower limb, hand power, and range of motion of cervical, thoracic, lumbosacral spines and other major joints were measured in two hundred fourteen elderly subjects. RESULTS: Subjects were divided into three groups according to age (group 1, 65~74 years; group 2, 75~84 years; group 3, above 85 years) and sex (male; female). Descriptive statistical analysis of data provided the following results. 1) Mean measurement in order of group 1-men, group 2-men, group 3-men followed by women of each group: Body weight (kg) - 60.2, 59.6, 54.9, 56.8, 51.6, 47.2; Standing height (cm) - 156.7, 160.8, 156.6, 151.2, 146.9, 142.2; Sitting height (cm) - 99.8, 100.8, 103.1, 100.9, 104.9, 97.0; Chest circumference (cm) - 91.5, 93.5, 91.4, 92.1, 89.5, 86.4; Upper limb length (cm) - 72.3, 72.5, 71.3, 67.1, 66.9, 65.4; Lower limb length (cm) - 82.3, 82.1, 81.4, 77.3, 76.1, 74.6. 2) The hand power of grasping, tip pinch, lateral pinch, palmar pinch showed a decreasing trend in older age group in both sexes. 3) The range of motion of cervical, thoracic, and lumbosacral spine in group 1 had limitation of about 50% compared to normal range. 4) Of the major joints, limitation of motion or deformity was most common in the shoulder and knee joints. CONCLUSION: These data and knowledge of physical parameters of the elderly can aid in design of living environment and assistive devices for elderly.
Aged* ; Body Weight ; Congenital Abnormalities ; Female ; Hand ; Hand Strength ; Humans ; Joints ; Knee Joint ; Lower Extremity ; Range of Motion, Articular ; Reference Values ; Self-Help Devices ; Shoulder ; Spine ; Thorax ; Upper Extremity

The clinical significance of hepatic resection for gastric metastases is controversial, even though hepatic resection has been widely accepted as a modality for colorectal metastases. Very few patients with gastric hepatic metastases are good candidates for hepatic resection because of multiple bilateral metastases, extrahepatic disease, or advanced cancer progression, such as peritoneal dissemination or extensive lymph node metastases. Therefore, several authors have reported the clinical significance of hepatic resection for gastric metastases in a small number of patients. Considering the present results with previous reports. The number and distribution of tumors in hepatic metastases from gastric cancer was considered based on the present and previous reports. Several authors have reported significantly better survival in patients with metachronous metastasis than in those with synchronous disease. However, metachronous hepatic resection necessitates the dissection of adhesions between the pancreas, liver, and residual stomach to prepare for Pringle's maneuver. Patients with unilobar liver metastasis, and/or metastatic tumors <4 cm in diameter may be good candidates for hepatic resection. Synchronous metastasis is not a contraindication for hepatic resection. Most of the long-term survivors underwent anatomic hepatic resection with a sufficient resection margin. After hepatic resection, the most frequent site of recurrence was the remaining liver, which was associated with a high frequency of mortality within 2 years. A reasonable strategy for improvement in survival would be to prevent recurrence by means of adjuvant chemotherapy and careful follow-up studies.
Chemotherapy, Adjuvant ; Follow-Up Studies ; Gastric Stump ; Humans ; Liver ; Lymph Nodes ; Neoplasm Metastasis ; Pancreas ; Recurrence ; Stomach Neoplasms ; Survivors

Robotic bariatric surgery renders it unnecessary for surgeons to manually apply torque while simplifying intracorporeal suturing. Surgeons can comfortably manipulate instruments. Also, the three-dimensional operative field is very clear. Unfortunately, robotic bariatric surgery is still not the first choice for morbidly obese patients in Korea because it currently is not covered by the National Healthcare Insurance system. In this video, we show the totally robotic Roux-en-Y gastric bypass conducted using robotic staplers, in a morbidly obese patient with diabetes mellitus and private medical insurance.

Morbid obesity requires active intervention, with treatment options including lifestyle modification, pharmacotherapy, and surgery. As the prevalence of obesity continues to rise in Korea, it is crucial for specialists and general practitioners to have a comprehensive understanding of obesity and its management. Bariatric surgery is the most effective treatment modality for obesity, leading to significant weight loss and metabolic benefits. It involves surgical alterations of normal anatomical structures to improve overall health. Therefore, selecting the appropriate procedure based on the individual characteristics of patients is crucial. This review highlights the two most commonly performed bariatric procedures worldwide, including in Korea: sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB). Furthermore, it provides a comprehensive overview of the surgical techniques involved in SG and RYGB, addresses potential complications, and presents findings from key studies on the weight loss and metabolic outcomes of these surgeries. Additionally, to support clinical application, the review provides outcome data for these procedures based on studies conducted in Korean populations. In addition to SG and RYGB, this review briefly introduces other surgical and endoscopic options, as well as pharmacological treatments that are currently available or may become viable options in the near future.

Morbid obesity requires active intervention, with treatment options including lifestyle modification, pharmacotherapy, and surgery. As the prevalence of obesity continues to rise in Korea, it is crucial for specialists and general practitioners to have a comprehensive understanding of obesity and its management. Bariatric surgery is the most effective treatment modality for obesity, leading to significant weight loss and metabolic benefits. It involves surgical alterations of normal anatomical structures to improve overall health. Therefore, selecting the appropriate procedure based on the individual characteristics of patients is crucial. This review highlights the two most commonly performed bariatric procedures worldwide, including in Korea: sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB). Furthermore, it provides a comprehensive overview of the surgical techniques involved in SG and RYGB, addresses potential complications, and presents findings from key studies on the weight loss and metabolic outcomes of these surgeries. Additionally, to support clinical application, the review provides outcome data for these procedures based on studies conducted in Korean populations. In addition to SG and RYGB, this review briefly introduces other surgical and endoscopic options, as well as pharmacological treatments that are currently available or may become viable options in the near future.

Morbid obesity requires active intervention, with treatment options including lifestyle modification, pharmacotherapy, and surgery. As the prevalence of obesity continues to rise in Korea, it is crucial for specialists and general practitioners to have a comprehensive understanding of obesity and its management. Bariatric surgery is the most effective treatment modality for obesity, leading to significant weight loss and metabolic benefits. It involves surgical alterations of normal anatomical structures to improve overall health. Therefore, selecting the appropriate procedure based on the individual characteristics of patients is crucial. This review highlights the two most commonly performed bariatric procedures worldwide, including in Korea: sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB). Furthermore, it provides a comprehensive overview of the surgical techniques involved in SG and RYGB, addresses potential complications, and presents findings from key studies on the weight loss and metabolic outcomes of these surgeries. Additionally, to support clinical application, the review provides outcome data for these procedures based on studies conducted in Korean populations. In addition to SG and RYGB, this review briefly introduces other surgical and endoscopic options, as well as pharmacological treatments that are currently available or may become viable options in the near future.

Morbid obesity requires active intervention, with treatment options including lifestyle modification, pharmacotherapy, and surgery. As the prevalence of obesity continues to rise in Korea, it is crucial for specialists and general practitioners to have a comprehensive understanding of obesity and its management. Bariatric surgery is the most effective treatment modality for obesity, leading to significant weight loss and metabolic benefits. It involves surgical alterations of normal anatomical structures to improve overall health. Therefore, selecting the appropriate procedure based on the individual characteristics of patients is crucial. This review highlights the two most commonly performed bariatric procedures worldwide, including in Korea: sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB). Furthermore, it provides a comprehensive overview of the surgical techniques involved in SG and RYGB, addresses potential complications, and presents findings from key studies on the weight loss and metabolic outcomes of these surgeries. Additionally, to support clinical application, the review provides outcome data for these procedures based on studies conducted in Korean populations. In addition to SG and RYGB, this review briefly introduces other surgical and endoscopic options, as well as pharmacological treatments that are currently available or may become viable options in the near future.