PURPOSE: Traditionally, nasogastric decompression has been a routine procedure following major abdominal surgery or gastrointestinal surgery. This prospective, randomized controlled trial was performed in order to evaluate the usefulness of nasogastric decompression following elective gastric cancer surgery. METHODS: This study was carried out prospectively. A total of 95 patients were randomly divided into two groups, group I (45 patients with nasogatric tube) and group II (50 patients without nasogastric tube). Patients receiving emergency surgery due to gastric outlet obstruction were excluded from this study. The data was analysed by chi-square test, T-test and Mann-Whitney U test with the level of significance set at P<0.05. RESULTS: No significant differences were found between the two groups in regards to nausea, vomting, distension, anastomotic leak or wound dehiscence. However, longer hospital stay, delayed passage of flatus, delayed initiation of ambulation, delayed start of feeding and sore throat occurred more often in group I patients than in group II patients. CONCLUSION: The result showed that the routine prophylactic use of nasogastric decompression following gastric cancer surgery is an unnecessary procedure and does not offer any considerable advantage.
Anastomotic Leak ; Decompression* ; Emergencies ; Flatulence ; Gastric Outlet Obstruction ; Humans ; Length of Stay ; Nausea ; Pharyngitis ; Prospective Studies* ; Stomach Neoplasms* ; Unnecessary Procedures ; Walking ; Wounds and Injuries

PURPOSE : Lung Cancer has been the leading cause of cancer deaths in South Korea since the year 2000, and its incidence continues to rise. Here we report the result of national survey of lung cancer conducted by Korean association for the study of lung cancer (KASLC). MATERIALS AND METHODS : A total of 8,788 lung cancer patients diagnosed in 2005 were registered using a web based case report form issued to hospitals equipped with more than 400 beds. RESULTS : The age distribution ranged from 11 to 105 years (64.7+/-0.7 years), 75.8% (6,664) of the patients were male and 28.9% of patients were never smokers. Subjective symptoms at the time of diagnosis included coughing (3,350 patients), dyspnea (2,105), chest pain (1,067), hemoptysis (805), weight loss (789), general weakness (498) and hoarseness (190), while 12% (1,015) of patients had no subjective symptoms. Of the carcinomas grouped into non-small cell lung carcinoma (NSCLC), adenocarcinoma including bronchoalveolar cell carcinoma (1.3%) was the most frequent (36.1%) histopathologic type, followed by squamous cell lung carcinoma (32.1%), large cell carcinoma (1.5%), unclassified non-small cell carcinoma (13.2%) and others (3.7%). In addition, 13.5% of all of the patients were afflicted with small cell lung carcinoma (SCLC). The stage at diagnosis was IA (7.3%), IB (10.2%), IIA (1.3%), IIB (6.1%), IIIA (12.8%), IIIB (21.6%), and IV (40.6%) in the NSCLC group. In SCLC group, 44.6% of the patients were in the limited stage, while 55.4% of the patients were in the extensive stage. The initial treatments included surgery (22.1%), radiation therapy (7.8%), chemo-radiation therapy (5.4%) and chemotherapy (38%), however, 26.6% of the patients were transferred or recorded to have supportive care only. Therefore we compared the outcomes of the Treatment Group (TG, 73.4%) and the Supportive Group (SG, 26.6%). The median survival time (MST) in months (m) was 28 (95% confidence interval 26.5~29.5 m). Multivariate analysis indicated that the independent prognostic factors for NSCLC were age, gender, ECOG PS score, stage, histopathologic type, and treatment or supportive care. In the SCLC group, age, PS score, stage, treatment or supportive care were significant prognostic factors. The TG group showed significantly superior survival when compared to the SG group, even in patients with stage IV disease and in patients that were >75 years old. CONCLUSION : Adenocarcinoma was found to be the most frequent histopathologic type, and active treatments were found to improve the survival of patients with lung cancer, even when they were in advanced stages or elderly
Adenocarcinoma ; Age Distribution ; Aged ; Carcinoma, Large Cell ; Chest Pain ; Cough ; Diagnosis ; Drug Therapy ; Dyspnea ; Hemoptysis ; Hoarseness ; Humans ; Incidence ; Korea* ; Lung Neoplasms* ; Lung* ; Male ; Multivariate Analysis ; Small Cell Lung Carcinoma ; Weight Loss

BACKGROUND: It is difficult to differentiate between tuberculous pneumonia and Community Acquired Pneumonia, so the diagnosis and treatment of tuberculous pneumonia can be delayed frequently. In this study, we attempted to retrospectively evaluate the clinical and radiologic characteristics of tuberculous pneumonia. METHODS: We conducted a retrospective analysis of clinical characteristics of 58 patients diagnosed with tuberculous pneumonia from Nov. 1997 to May 2001 at Korea university kuro hospital. RESULT: The male to female ratio was 1:1 and the mean age at diagnosis was 54.5+/-18.6 years. Fifty five patients were confirmed microbiologically and three patients pathologically. There were 20 patients(34.5%) who had diabetes mellitus(8cases), chronic obstructive pulmonary disease(3cases), malignancy(3cases), bronchiectasis(2cases), chronic renal failure(1cases) or long term history of corticosteroid treatment(3cases). Many patients had multilobar infiltration in chest X-ray, dominantly in the lower lobe. thirty two patients(55.2%) had infiltration in more than 2 lobes and 5 patients in more than 4 lobes. The significant correlation between the diabetes mellitus and the infiltrated Rt lower lobe(RLL) was found on the borders of confidence limit.(P=0.07<0.1). There was significant correlation between woman and infiltrated lobe(RML, RLL, LLL) excluding the both upper lobe(P=0.029). CONCLUSION: We must consider tuberculous pneumonia when lobar pneumonia with consolidation resistant to antibiotics, especially in the patients who have diabetes mellitus, chronic obstructive pulmonary disease, malignancy, bronchiectsis, chronic renal failure or long term history of corticosteroid treatment.
Anti-Bacterial Agents ; Diabetes Mellitus ; Diagnosis ; Female ; Humans ; Kidney Failure, Chronic ; Korea ; Male ; Pneumonia* ; Pulmonary Disease, Chronic Obstructive ; Retrospective Studies ; Thorax

Paraneoplastic limbic encephalitis (PLE) is a rare syndrome characterized by memory impairment, affective and behavioral disturbances and seizures. Among many different neoplasms known to cause PLE, small cell lung cancer (SCLC) is the most frequently reported. The pathogenesis is not fully understood but is believed to be autoimmune-related. We experienced a patient with typical clinical features of PLE. A 67-year-old man presented with seizure and disorientation. Brain magnetic resonance imaging demonstrated high signal intensity in the bilateral amygdala and hippocampus in flair and T2-weighted images suggestive of limbic encephalitis. Cerebrospinal fluid tapping revealed no evidence of malignant cells or infection. Positron emission tomography/computed tomography showed a lung mass with pleural effusion and a consequent biopsy confirmed the diagnosis of PLE associated with SCLC. The patient was subsequently treated with chemotherapy and neurologic symptoms gradually improved.
Aged ; Amygdala ; Biopsy ; Brain ; Electrons ; Hippocampus ; Humans ; Limbic Encephalitis ; Lung ; Lung Neoplasms ; Magnetic Resonance Imaging ; Memory ; Neurologic Manifestations ; Paraneoplastic Syndromes ; Pleural Effusion ; Seizures ; Small Cell Lung Carcinoma

PURPOSE: Female lung cancers have different clinical features and therapeutic results as compared to those of male lung cancers. The aim of this study was to analyze the differences of Korean men and women with lung cancer. MATERIALS AND METHODS: We re-analyzed the results of a national survey of lung cancer conducted by the Korean Association for the Study of Lung Cancer in 2005. RESULTS: Of the 8,788 patients, 2,124 (24.2%) were female. The mean age at the diagnosis was 62.5 years for the females and 64.8 years for the males and the difference was significant (p<0.001). An age <50 years was more frequent for the women than for the men (16.2% vs. 7.9%, respectively; p=0.001). The stages between genders were different for the patients with non-small cell carcinoma (NSCLC) (p<0.001), but not for the patients with small cell carcinoma. The overall survival time was longer for woman than that for the man (p<0.001). However, the male patients had longer survival for the smokers with adenocarcinoma and the smokers with squamous cell carcinoma. The never smoker female patients had a better survival time than did the smoking female patients, but the male patient' survival was not influenced by the smoking status. The stage-specific survival rates were better for the women at all stages of NSCLC (p<0.001). The women who received chemotherapy had a longer survival time did the men who received chemotherapy (p<0.001). CONCLUSION: Women with lung cancer were relatively overrepresented among the younger patients and they smoked less intensively, raising the question of gender- specific differences in the carcinogenesis of lung cancer. Over-representation of adenocarcinoma was observed in the women regardless of their smoking status. Women with lung cancer had a better prognosis than men; however, the smoking females showed the worst prognosis. Gender and the smoking status are clearly important factors in the therapeutic approach to lung cancer.
Adenocarcinoma ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Female ; Humans ; Korea ; Lung ; Lung Neoplasms ; Male ; Prognosis ; Republic of Korea ; Smoke ; Smoking ; Survival Rate