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박준성,정혜경,황호경,김재근,윤동섭 대한의학회 2012 Journal of Korean medical science Vol.27 No.3
The benefits of early enteral feeding (EEN) have been demonstrated in gastrointestinal surgery. But, the impact of EEN has not been elucidated yet. We assessed the postoperative nutritional status of patients who had undergone pancreaticoduodenectomy (PD) according to the postoperative nutritional method and compared the clinical outcomes of two methods. A prospective randomized trial was undertaken following PD. Patients were randomly divided into two groups; the EEN group received the postoperative enteral feed and the control group received the postoperative total parenteral nutrition (TPN) management. Thirty-eight patients were included in our analyses. The first day of bowel movement and time to take a normal soft diet was significantly shorter in EEN group than in TPN group. Prealbumin and transferrin were significantly reduced on post-operative day (POD) 7 and were slowly recovered until POD 90 in the TPN group than in the EEN group. EEN group rapidly recovered weight after POD 21 whereas it was gradually decreased in TPN group until POD 90. EEN after PD is associated with preservation of weight compared with TPN and impact on recovery of digestive function after PD.
옥시코돈 과다 복용 후 발생한 횡문근융해증과 다발신경근병증 - 증례 보고 -
박준성,김주섭,이태임,허원석,심재원,한인수,김보라,서인석 대한근전도전기진단의학회 2010 대한근전도 전기진단의학회지 Vol.12 No.2
Pure oxycodone overdose presents with a typical opioid toxidrome, including decreased respirations, miosis,hypothermia, bradycardia, hypotension, and altered mental status. We report a 38-year-old male with paraplegia, diagnosed rhabdomyolysis and polyradiculoneuropathy after oxycodone overdose. After conservative care, the vital signs and laboratory findings became stable. However, physical examination of muscle strength and sensation revealed no improvement (Medical Research Council [MRC] scores in both lower extremities 1~3). Fat-suppressed T2-weighted MR image displayed ill-defined areas of high signal intensity in muscles and adjacent soft tissues of bilateral proximal thigh. Electrodiagnostic studies were consistent with polyradiculoneuropathy. After rehabilitation management, he could ambulate with bilateral quad-canes despite weakness of both lower extremities.