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Prognosis and Treatment Outcomes of Gastric Cancer Patients with Hepatic Metastasis (간전이 위암환자의 치료 결과 및 예후)

  • Kim, Eun-Mi;Kim, Se-Won;Kim, Sang-Woon;Lee, Kyung-Hee;Hyun, Myung-Soo;Park, Won-Kyu;Chang, Jae-Chun;Song, Sun-Kyo
    • Journal of Gastric Cancer
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    • v.6 no.4
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    • pp.237-243
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    • 2006
  • Purpose: This study was conducted to evaluate the treatment outcomes and the prognosis for gastric cancer patients with hepatic metastasis. Materials and Methods: This retrospective study was based on the medical records of 85 gastric cancer patients with hepatic metastasis (62 synchronous and, 23 metachronous) who received chemotherapy with or without resectional therapy from March 1990 to March 2006. The survival rate was analyzed according to clinicopathologic factors and therapeutic factors, such as whether or not a gastrectomy, a hepatic resection, and/or chemotherapy had been performed. Results: The median survival of gastric cancer patients with hepatic metastasis was 11 months (synchronous: 11 months and metachronous: 17 months). The rates of gastrectomies and hepatic resections in the synchronous group were 24.1% and 16.1%, respectively A 23.5% prevalence of extra-hepatic metastasis was observed. The median survivals of patients who underwent a gastrectomy with a hepatic resection, a gastrectomy alone, and non-surgical treatment were 60, 18, and 9 months, respectively (P<0.05). The disease-free median survival of the metachronous group was 8 ($3{\sim}39$) months. There was no difference in initial pathologic stage and frequency of hepatic metastasis after the gastrectomy in the metachronous group. In the synchronous group, extra-hepatic metastasis, a gastrectomy as the operative procedure, a hepatic resection as the operative procedure and the response to chemotherapy were statistically significant in the univariate analysis, and a hepatic resection as the operative procedure, the response to chemotherapy, and extra-hepatic metastasis were independant prognostic factors identified by the multivariate analysis. In the metachronous group, extra-hepatic metastasis, the response to chemotherapy and differentiation were statistically significant in the univariate analysis, and extra-hepatic metastasis was an independent prognostic factor identified by the multivariate analysis. Conclusion: An aggressive surgical therapy and effective chemotherapy are necessary in the treatment of gastric cancer patients with hepatic metastasis. (J Korean Gastric Cancer Assoc 2006;6:237-243)

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Clinicopathological Features and Prognostic Factors for Patients with Clinical T4 Gastric Cancer that Underwent Combined Resection of Invaded Organs (위암의 주위 장기 침윤으로 합병 절제를 실시한 환자의 병리학적 병기 및 예후)

  • Byun, Gun-Young;Park, Joong-Min;Kim, He-Il;Kim, Jong-Han;Park, Sung-Soo;Kim, Seong-Ju;Mok, Young-Jae;Kim, Chong-Suk
    • Journal of Gastric Cancer
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    • v.7 no.3
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    • pp.117-123
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    • 2007
  • Purpose: The surgical treatment of gastric cancer that invades adjacent organs is a radical gastrectomy with combined resection including the adjacent organs or a palliative operation by performing either a gastrojejunostomy or gastrectomy. However, since it is impossible to determine the exact stage of the cancer, either T or N, in the case of palliative surgery, it is inappropriate to predict patient prognosis. This study analyzes the prognoses for patients whose final TNM stages are determined by a combined resection performed due to macroscopical infiltration into the adjacent organs. Materials and Methods: Of 2,452 patients that underwent surgery for gastric cancer at our hospital from 1983 to 2002, we evaluated 102 patients where a combined resection was performed because direct infiltration into the adjacent organs was discovered. Results: Univariate analysis showed that the survival rate differed by the depth of invasion into the gastric walls, the degree of lymph node metastasis, distant metastasis, pathological TNM stage, surgical curability, the location of tumor, and histological differentiation. By multivariate analysis, it was found that the surgical curability, the location of the tumor and the degree of lymph node metastasis were independent prognostic factors. Conclusion: It is suggested that even when infiltration into adjacent organs is suspected, radical surgery should be performed as to allow a prediction of prognosis through an exact determination of disease stage, and to improve the survival rate.

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Influence of Gating and Attenuation-correction for Diagnostic Performance of Usual Rest/stress Myocardial Perfusion SPECT in Coronary Artery Disease (게이트 방법과 감쇠보정이 심근 관류 SPECT의 관상동맥질환 진단 성능에 미치는 영향)

  • Lee, Dong-Soo;Yeo, Jeong-Seok;So, Young;Cheon, Gi-Jeong;Kim, Kyeong-Min;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.2
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    • pp.131-142
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    • 1999
  • Purpose: Either gated myocardial perfusion SPECT or attenuation corrected SPECT can be used to improve specificity in the diagnosis of coronary artery disease. We investigated in this study whether gating or attenuation correction improved diagnostic performance of rest/stress perfusion SPECT in patients having intermediate pre-test likelihood of coronary artery disease. Materials and Methods: Sixty-eight patients underwent rest attenuation-corrected T1-20l/dipyridamole stress gated attenuation-corrected Tc-99m -MIBI SPECT using an ADAC vertex camera (M:F=29:39, aged $59{\pm}12$ years, coronary artery stenosis ${\geq}70%$, one vessel: 13, two vessel: 18, three vessel: 8, normal: 29). Using a five-point scale, three physicians graded the post-test likelihood of coronary artery disease for each arterial territory (1:normal, 2: possibly normal, 3:equivocal, 4. possibly abnormal, 5: abnormal). Sensitivity, specificity and area under receiver-operating-characteristic curves were compared for each operator between three methods : (A) non-attenuation-corrected SPECT; (B) gated SPECT added to (A): and (C) attenuation-corrected SPECT added to (B). Results: When grade 3 was used as the criteria for coronary artery disease, no differences in sensitivity and specificity were found between the three methods for each operator. Areas under receiver-operating-characteristic curves for diagnosis of coronary artery disease revealed no differences between each modality (p>0.05). Conclusion: In patients at intermediate risk of coronary artery disease, gated SPECT and attenuation- corrected SPECT did not improve diagnostic performance.

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Diagnostic Criteria of $^{99m}Tc$-diethylenetriaminepentaacetic acid Captopril Renal Scan for the Diagnosis of Renovascular Hypertension by Unilateral Renal Artery Stenosis ($^{99m}Tc$-diethylenetriaminepentaacetic acid 캅토프릴 신장스캔의 단측 신동맥 협착에 의한 신혈관성고혈압 진단 기준)

  • Choi, Seung-Jin;Hong, Il-Ki;Chang, Jae-Won;Park, Su-Kil;Moon, Dae-Hyuk
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.6
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    • pp.498-505
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    • 2004
  • Purpose: We compared captopril renal scintigraphic criteria for the diagnosis of renovascular hypertension by unilateral renal artery stenosis. Materials and Methods: The study group consisted of 24 patients (m/f : 16/8, age: $39{\pm}18$ years) with unilateral renal artery stenosis who underwent renal artery revascularization and captopril renal scintigraphy with $^{99m}Tc$-diethylenetriaminepentaacetic acid between May 1995 and April 2004. The blood pressure response was classified as cure/improvement or failure. We evaluated captopril-induced changes in relative function (BCfun) and renogram grade (0 to 5: 0=normal, and 5=renal failure pattern without measurable uptake) (CBren) and the difference of renograms between the normal and stenotic kidney on captopril scan (CNren). Results: light of 24 patients were cured and 11 improved and 5 patients were classified as failed revascularization. Significant predictors of a cure or improvement of blood pressure were younger age, stenosis by fibromuscular dysplasia or arteritis, BCfun, CBren and CNren. Areas under the receiver operating characteristic curve of age, BCfun, CBren and CNren were not significantly different. Positive and negative predictive values of predictors were 100% and 42% (age ${\leq}38$): 92% and 50% (BCfun ${\geq}1%$): 92% and 75% (CBren ${\geq}1$), and 90% and 60% (CNren ${\geq}1$), respectively. Conclusion: Captopril induced changes in renal function and renogram can reliably predict hypertension response to revascularization. Renogram pattern on captopril scan can diagnose renovascular hypertension without baseline data in patients with unilateral renal artery stenosis.

Differences of Tc-99m HMPAO SPECT Imaging in the Early Stage of Subcortical Vascular Dementia Compared with Alzheimer's Disease (초기 단계의 피질하 혈관성 치매와 알쯔하이머병에서 Tc-99m HMPAO SPECT 영상 소견 차이)

  • Park, Kyung-Won;Kang, Do-Young;Park, Min-Jeong;Cheon, Sang-Myung;Cha, Jae-Kwan;Kim, Sang-Ho;Kim, Jae-Woo
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.6
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    • pp.530-537
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    • 2007
  • Purpose: The aim of this study is to assess the specific patterns of regional cerebral blood flow (rCBF) in patients with the early stage of subcortical vascular dementia (SVaD) and Alzheimer's disease (AD) using Tc-99m HMPAO SPECT, and to compare the differences between the two conditions. Materials and Methods: Sixteen SVaD, 46 AD and 12 control subjects participated in this study. We included the patients with SVaD and AD according to NINCDS-ADRDA and NINDS-AIREN criteria. They were all matched for age, education and clinical dementia rating scores. Three groups were evaluated by Tc-99m HMPAO SPECT using statistical parametric mapping (SPM) for measuring rCBF. The SPECT data of patients with SVaD and AD were compared with those of normal control subjects and then compared with each other. Results: SPM analysis of the SPECT image showed significant perfusion deficits on the right temporal region and thalamus, left insula and superior temporal gyrus, both cingulate gyri and frontal subgyri in patients with SVaD and on the left supramarginal gyrus, superior temporal gyrus, postcentral gyrus and inferior parietal lobule, right fugiform gyrus and both cingulate gyri in AD compared with control subjects (uncorrected p<0.01). SVaD patients revealed significant hypoperfusion in the right parahippocampal gyrus with cingulated gyrus, left insula and both frontal subgyral regions compared with AD (uncorrected p<0.01). Conclusion: Our study shows characteristic and different pattern of perfusion deficits in patients with SVaD and AD, and these results may be helpful to discriminate the two conditions in the early stage of illness.

A Study of Production Techniques of the Handles of Swords with Round Pommel Excavated from Jeollabuk-do Made in Before 6 Century (6세기 이전 제작된 전라북도 출토 소환두도의 병부(柄部) 제작기법 연구)

  • Lee, Young-Beom;Seo, Jeong-Ho
    • Journal of Conservation Science
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    • v.25 no.1
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    • pp.1-16
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    • 2009
  • Jeollabuk-do is bounded by the sea, and Mahan Baekje culture have been established around a wide plain. Also, in southeastern, it was closed by Gaya kingdom where iron culture was prosperous at that time, a variety of the handles of swords with round pommel is excavated at present. The handles of swords with round pommel is the best amount of excavated objects among the swords with round pommel and producted object for the time. It supposes them to become the foundation of making the decorated swords with round pommel. But, the handles of swords with round pommel that don't have a pattern in handle is indifferent to study because the production method is simple in spite of that the value of archaeological data is sufficient. Therefore, in this study, it examined changed production techniques with the change of times concerning the handles of swords with round pommel of Mahan Baekje Gaya period(before 6C) excavated from Jeollabukdo through using X-rays in order to clarify a variety of production techniques of the handles of swords with round pommel correctly in accordance with a period of production and excavated place. As a result, identified production techniques using X-rays of the handles of swords with round pommel excavated around remains of Mahan Baekje Gaya period shows that production progress improved in order of all-in-one shape, hammer welding shape of the handle of round pommel, and two in body formation in accordance with age. Especially, in two in body shape, it products the handle of round pommel separately, after that it welds the handle of swords and then links the sword blade like a riveting or bottleneck and so on. Despite of improved hammer welding technique, the reason why it didn't utilize is it regards as inlay or gilt will be damaged. And it is judged by using riveting or bottleneck. Also, it appears to techniques of metal craft such as decoration of the handle, decoration of point of sword, inlay, and silver-plating in the period of appearing two in body shape. As clarifying correctly, it provides fundamental database of scientific research about a study of production techniques of handle of swords with round pommel.

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Comparison of Foodservice Management Practices in the Employee Feeding Operations of Jeonnam and Chungchong Area (전남과 충청지역 사업체 급식소의 급식관리 실태 조사 비교연구)

  • 서희영;정복미
    • Korean Journal of Community Nutrition
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    • v.9 no.2
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    • pp.191-203
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    • 2004
  • This study was performed to compare the foodservice management practices in the employee feeding operations of Jeonnam and Chungchong area. Questionnaires were developed and mailed to 160 dietitians with management in employee foodservice of Jeonnam and Chungchong area. Completed questionnaires were received from 124 dietitians with a response rate of 77.5%. The results of this study can be summarized as follows:. Age, work experience, concurrent position and work time of dietitians were significantly higher in the Chungchong area than those in the Jeonnam area. Times of meals and amount of meals served per day in the Chungchong area were significantly higher than those in the Jeonnam area. The type of menu by foodservice operation was high non-selective menu in both areas, especially non-selective menu was high in self-operated place whereas selective menu was high in contract management. Period of cycle menu was 10-15 days in Jeonnam area, but that was 7 days in Chungchong area and so cycle menu of both areas was significantly different (p < 0.001). Most considerable factor in menu planning was preference in Jeonnam area and was cost in the Chungchong area. Food purchasing method was used mostly by automatic computerized order in the Jeonnam area whereas telephone or mail order was high in the Chungchong area.

Isolation and Characterization of Antifungal Compounds Produced by Bacillus polyfermenticus CJ6 Isolated from Meju (메주에서 분리한 Bacillus polyfermenticus CJ6가 생산하는 항진균 물질의 분리 및 특성)

  • Yang, Eun-Ju;Ma, Seung-Jin;Chang, Hae-Choon
    • Microbiology and Biotechnology Letters
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    • v.40 no.1
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    • pp.57-65
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    • 2012
  • Antifungal compounds from Bacillus polyfermenticus CJ6 were purified using SPE, preparative HPLC, and reverse phase-HPLC. Antifungal compounds from B. polyfermenticus CJ6 were separated into three fractions (8, B, C) using preparative HPLC. LC/MS analysis of antifungal peaks suggested that B. polyfermenticus CJ6 produces lipopeptides; two kinds of iturin A ($C_{14}$, $C_{15}$), three kinds of surfactins ($C_{13}$, $C_{14}$, $C_{15}$), four kinds of fengycin A ($C_{14}$, $C_{15}$, $C_{16}$, $C_{17}$) and two kinds fengycin B ($C_{16}$, $C_{17}$). The antifungal activity of fraction 8, which was presumed as inturin A, was found to be stable after the pH, heat or proteolytic enzyme treatment, but it was unstable at 50-$70^{\circ}C$ for 24 hr. The antifungal activity of fraction B, which presumed as surfactins and fengycin A, was found to be stable after the heat treatment, but it was unstable in the pH 3.0 and after the protease (type I) or ${\alpha}$-chymotrypsin treatment. The antifungal activity of fraction C, which was presumed as fengycin A and B, was found to be stable in the pH 3.0-9.0 range and the heat treatment, but it was unstable with the treatment of protease (type I). The amino acid composition of the purified peaks 8-1 and 8-2 were Asx, Tyr, Gln, Pro, and Ser in a molar ratio of 3:1:1:1:1, which showed the same amino acid composition as iturin. From these results, we confirmed that antifungal compounds from B. polyfermenticus CJ6 most likely belonged to iturin A as well as surfactins and fengycins. As lipopeptides are known to act in a synergistic manner, the antifungal compounds from B. polyfermenticus CJ6 might have potential uses in biotechnology and biopharmaceutical applications.

Effect of moisture on sealing ability of root canal filling with different types of sealer through the glucose penetration model (수종의 실러를 이용한 근관 충전 시 근관 내 수분이 치근단 폐쇄효과에 미치는 영향)

  • Jang, Jin-Ah;Kim, Hee-Lyang;Her, Mi-Ja;Lee, Kwang-Won;Yu, Mi-Kyung
    • Restorative Dentistry and Endodontics
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    • v.35 no.5
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    • pp.335-343
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    • 2010
  • Objectives: To compared the effect of different levels of moisture of root canal on the sealing ability after filling with four different types of sealer. Materials and Methods: Single-rooted teeth (n = 90) instrumented to and apical size of 0.06 / 45 were randomly assigned to 12 experimental groups (n = 7 per group), positive/negative control groups (n = 3 per group). The teeth of the experimental groups (a. DRY; b. PAPER POINT DRY; c. WET) were obturated with sealer (Group 1-3: Sealapex; Group 4-6: AH plus; Group 7-9: Tubuli-seal; Group 10-12: EndoRez) and warm vertical compaction method. After 7 days in $37^{\circ}C$, 100% humidity, the coronal-to-apical microleakage was evaluated quantitatively using a glucose leakage model. The leaked glucose concentration was measured with spectrophotometer at 1, 3, 7, 14, 21, and 30 days. Data were recorded ad mmol/L and statistically analysed with the two-way ANOVA and Duncan test (p = 0.05). Results: Throughout the experimental period Tubuli-seal/WET (Group 9) showed the highest mean cumulative glucose penetration (178.75 mmol/L), whereas AH plus/DRY (Group 4) had the least (20.78 mmol/L). Conclusions: The results of this study demonstrated that the moisture condition of root canals at the time of obturation and the type of sealer that was used had a significant effect on leakage and sealing ability. Thus drying procedure according to sealer types is a critical step and should not be missed in endodontic treatment.

An Investigation on Expanding Co-occurrence Criteria in Association Rule Mining (연관규칙 마이닝에서의 동시성 기준 확장에 대한 연구)

  • Kim, Mi-Sung;Kim, Nam-Gyu;Ahn, Jae-Hyeon
    • Journal of Intelligence and Information Systems
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    • v.18 no.1
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    • pp.23-38
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    • 2012
  • There is a large difference between purchasing patterns in an online shopping mall and in an offline market. This difference may be caused mainly by the difference in accessibility of online and offline markets. It means that an interval between the initial purchasing decision and its realization appears to be relatively short in an online shopping mall, because a customer can make an order immediately. Because of the short interval between a purchasing decision and its realization, an online shopping mall transaction usually contains fewer items than that of an offline market. In an offline market, customers usually keep some items in mind and buy them all at once a few days after deciding to buy them, instead of buying each item individually and immediately. On the contrary, more than 70% of online shopping mall transactions contain only one item. This statistic implies that traditional data mining techniques cannot be directly applied to online market analysis, because hardly any association rules can survive with an acceptable level of Support because of too many Null Transactions. Most market basket analyses on online shopping mall transactions, therefore, have been performed by expanding the co-occurrence criteria of traditional association rule mining. While the traditional co-occurrence criteria defines items purchased in one transaction as concurrently purchased items, the expanded co-occurrence criteria regards items purchased by a customer during some predefined period (e.g., a day) as concurrently purchased items. In studies using expanded co-occurrence criteria, however, the criteria has been defined arbitrarily by researchers without any theoretical grounds or agreement. The lack of clear grounds of adopting a certain co-occurrence criteria degrades the reliability of the analytical results. Moreover, it is hard to derive new meaningful findings by combining the outcomes of previous individual studies. In this paper, we attempt to compare expanded co-occurrence criteria and propose a guideline for selecting an appropriate one. First of all, we compare the accuracy of association rules discovered according to various co-occurrence criteria. By doing this experiment we expect that we can provide a guideline for selecting appropriate co-occurrence criteria that corresponds to the purpose of the analysis. Additionally, we will perform similar experiments with several groups of customers that are segmented by each customer's average duration between orders. By this experiment, we attempt to discover the relationship between the optimal co-occurrence criteria and the customer's average duration between orders. Finally, by a series of experiments, we expect that we can provide basic guidelines for developing customized recommendation systems. Our experiments use a real dataset acquired from one of the largest internet shopping malls in Korea. We use 66,278 transactions of 3,847 customers conducted during the last two years. Overall results show that the accuracy of association rules of frequent shoppers (whose average duration between orders is relatively short) is higher than that of causal shoppers. In addition we discover that with frequent shoppers, the accuracy of association rules appears very high when the co-occurrence criteria of the training set corresponds to the validation set (i.e., target set). It implies that the co-occurrence criteria of frequent shoppers should be set according to the application purpose period. For example, an analyzer should use a day as a co-occurrence criterion if he/she wants to offer a coupon valid only for a day to potential customers who will use the coupon. On the contrary, an analyzer should use a month as a co-occurrence criterion if he/she wants to publish a coupon book that can be used for a month. In the case of causal shoppers, the accuracy of association rules appears to not be affected by the period of the application purposes. The accuracy of the causal shoppers' association rules becomes higher when the longer co-occurrence criterion has been adopted. It implies that an analyzer has to set the co-occurrence criterion for as long as possible, regardless of the application purpose period.