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Comparison of the Reconstruction Routes after Esophagectomy for Esophageal Cancer (식도암 절제후 식도 재건경로의 비교)

  • Lee, Seung-Yeoll;Kim, Kwang-Taik;Choi, Young-Ho;Kim, Il-Hyun;Baik, Man-Jong;Sun, Kyung;Lee, In-Sung;Kim, Hyoung-Mook
    • Journal of Chest Surgery
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    • v.32 no.9
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    • pp.806-812
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    • 1999
  • Background: Selection of reconstruction route in esophageal cancer surgery is based on the patient's status, characteristics of tumor, surgeon's preference and experience. Of the various routes, it has been documented that subcutaneous or substernal route may prolong operation time and may be vulnerable to postoperative respiratory complications. This study was designed to evaluate whether the selection of reconstruction route affects the surgical outcomes. Material and Method: Of 131 patients who have undergone resection and reconstruction for esophageal cancer, posterior mediastinal route(Group I, n=34), substernal route (Group II, n=31), and subcutaneous route(Group III, n=21) were retrospectively reviewed in 86 patients. Results of early operations and morbidities were compared between the groups. Result: There was a male prevalence(79 of males vs. 7 of females). There were 81 squamous cell cancers and 5 adenocarcinomas. There were no differences between groups in weight, height, age, cancer staging and location, and in the preoperative anesthetic risk evaluation and pulmonary function test(p=NS). Postoperative mechanical ventilation time was longer in Group I(20.6 hours) than in Group II(7.8 hours) or III(3.4 hours)(p=0.005). Duration of stay in the intensive care unit was prolonged in Group III(6.4 days) compared to Group I (3.9 days) or II(3.1 days)(p=0.043). No differences were noted in the duration of hospital stay between the groups(p=NS). Blood transfusion was needed in 30 out of 34 patients in Group I compared to 14/31 in Group II or 15/21 in Group III(p=0.001). The mean amount of transfusion for each patient was also higher in Group I(3,833 mL) than in Group II(1535 mL) or Group III(1419 mL)(p=0.04), but there was no difference in the inreoperation due to bleeding. Ea ly mortality rate was substantially higher in Group I(17.6%) but the differences between the groups were insignificant(p=NS). Although sepsis was a more prevalent cause of death in Group I, it was not related to anastomotic leak. Other morbidities did not differ between the groups(p=NS). Conclusion: In above results show that the reconstruction route does not affect the outcome of esophageal cancer surgery. We believe that the selection of reconstruction route can be based on the surgeon's preference and experience.

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Preservation of Subvalvular Apparatus During Mitral Valve Replacement (판막하부 구조물을 보존하는 인공 승모판막 치환술)

  • 임창영;임정철
    • Journal of Chest Surgery
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    • v.29 no.12
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    • pp.1329-1336
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    • 1996
  • From January, 1994 to January. 1996, mitral valve replacement was performed in 27 patients. Among these, 17 patients underwent mitral valve replacement(MVR) with preservation of the annulo-papillary continuity(PAPCMVR) (-Group I), and 10 patients underwent conventional methods of excision of all the chordae(Group II). The operative technique for PAPCM VR consists of the division of the anterior leaflet into anterior and posterior segments, shifting and reattachment of the divided segments to the mitral ring of the respective commissural areas. This retrospective study has been designed to evalute the postoperative left ventricular function in the two groups. In the group 1, LVEF(Left Vnetricular Ejection Fraction : %) was 52 $\pm$ 3 preoperatively And 50$\pm$3 postoperatively, LVESI Vent icular End Systolic Volume Index/mL/m2) wIns 59 :6 and 51 $\pm$ 7, LVEDI Ventricular End Diastolic Volume Index/mL/m2) was 124$\pm$ 11 and 91 :8. In the group II, LVEF was 56$\pm$1 and 47:), LVESVI 62$\pm$12 and 61$\pm$15, LVEDVI 133$\pm$27 and 104$\pm$17. : the variation of the LVEF in these two group was statistically different(p(0.05). A comparison of left ventricular function data between Group I(n: 17) and Group II(n: 10) revealed better results in echocardiographic LVEF(p<0.05), LVEDVI(p<0.01) in the former group. The mean functional class(UYHA) was 2.6 preoperative and improved to 1.0 postoperatively In group 1, and 2.8 and to 1.0 in group II. We conclude that maintenance of continuity between the mitral annulus and papillary muscles is expected to have a beneficial effect on postoperative left ventricular performance.

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Fertilizer Recommendation Based on Soil Testing for Tomato in Plastic Film House (토양검정에 의한 시설재배 토마토의 적정 시비량 추천)

  • Hong, Soon-Dal
    • Korean Journal of Soil Science and Fertilizer
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    • v.31 no.4
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    • pp.350-358
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    • 1998
  • To determine the optimum application of fertilizers for the cultivation of tomato in plastic film house, eighteen soils which contained different salt contents were taken from four different areas under plastic film house cultivation, Youngdong, Boeun, Cheongweon county, and Cheongju city. The dry weight and the amount of N, P, and K uptakes of tomato in the plot with no fertilization were considered as the factors representing the fertility of the soil. The differences in the dry weight and in the amounts of N, P, and K uptakes of plants between the plots with fertilization and with no fertilization were considered as the factors representing the total effect of fertilizer and the effects of fertilizer N, P, and K, respectively. These factors of soil fertility and fertilizer effects were estimated by correlation and regression with the chemical properties of the soil in order to find the critical levels and recommended method for optimum fertilization of tomato. The standardized partial regression coefficients of inorganic nitrogen ($NO_3-N+NH_4-N$) contents in soil for the factors of fertility ranged from 247 to 1,159, showing the best, while those of the others ranged from 0.02 to 4.02. Those of inorganic nitrogen ($NO_3-N+NH_4-N$) contents in soil for the electrical conductivity were also the best and were ranged from 35.2 to 36.0 compared with the values of less than 1.0 of the others. These results demonstrate that the content of inorganic nitrogen in the soil is the best index for both soil fertility and electrical conductivity of the soil. The critical level of inorganic nitrogen ($NO_3-N+NH_4-N$) in the soil for maximum productivity with zero value of fertilizer effects for tomato, estimated through Cate-Nelson split method was $220mg\;kg^{-1}$. This was the same value as evaluation for the cultivation of chinese cabbage. In conclusion, for optimal application of fertilizer in plastic film house, 1) no fertilization is recommended when the contents of inorganic nitrogen in the soil is more than $220mg\;kg^{-1}$; however, 2) in the case of less than $220mg\;kg^{-1}$ of inorganic nitrogen content in the soil, the optimal level of fertilization could be estimated through the regression equation between fertilizer effects and content of inorganic nitrogen in the soil.

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Changes of Soil-Emission Gases and Microbial Diversity by Different Fertilizers Supplemented after Application of Livestock-Manure Compost in Greenhouse Soil (시설재배지(施設栽培地)에서 축분퇴비(畜糞堆肥) 시용시(施用時) 보충비종(補充費種)에 따른 토양배출(土壤排出)가스 및 미생물다양성(微生物多樣性)의 변화(變化))

  • Kang, Hang-Won;Ko, Jee-Yeon;Park, Hyang-Mee;Lee, Jae-Saeng;Rang, Ui-Gum;Park, Kyeong-Bae
    • Korean Journal of Soil Science and Fertilizer
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    • v.33 no.1
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    • pp.52-60
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    • 2000
  • This study was conducted to gain basic data for alleviation of gas emission and conservation of healthy soil environment by investigating an aspect of gas emission and microbial diversity due to the supplement of different fertilizers after application with a livestock manure compost in greenhouse soils. Green pepper was cultivated in clay loamy soil from April to August. Before planting, a livestock manure compost was applied with $741mg\;ha^{-1}$ on the basis of the phosphate content contained in compost. And then, deficient nitrogen for cropping was supplemented with either quick-acting fertilizer of urea or a controlled slow release fertilizer made from urea formaldehyde(U/F). $NH_3$ and R $NH_2$ gases emitted from soil showed a low concentration in the early stage but a maximum in 27 days after planting, then decreased rapidly and not detected after 33 days. Their average concentrations were 42% and 85% lower in the treatment of slow release fertilizer than that of urea fertilizer, respectively. $CO_2$ gas emitted under urea fertilization was ranged from 1,200 to $3,200mg{\ell}^{-1}$ and that in slow release fertilizer was $900{\sim}2,650mg\;{\ell}^{-1}$. The average concentration of urea treatment was $2,260mg{\ell}^{-1}$ and 30% higher than that of slow release fertilizer. The treatment of slow release fertilizer with the lapse of cropping time populated larger in numbers of bacteria, actinomycetes, nitrate bacteria and nitrate reduction bacteria, and ratios of bacteria and actinmycetes to fungi than that of urea fertilizer. But the number of fungi was higher in the treatment of urea fertilizer and denitrifying bacteria showed a similar trend in both treatments. The microbial diversity index, which calculated with numbers of 6 species of microorganisms, was decreased with increasing of growing stage in the range of 0.1 to 0.35 and that was higher in the tratment of slow release fertilizer than urea.

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Smad6 Gene and Suppression of Radiation-Induced Apoptosis by Genistein in K562 Cells (K562 세포주에서 Genistein에 의해 억제되는 Radiation-induced Apoptosis의 조절 유전자)

  • Jeong, Soo-Jin;Jin, Young-Hee;Yoo, Yeo-Jin;Do, Chang-Ho;Jeong, Min-Ho;Huh, Gi-Yeong;Bae, Hye-Ran;Yang, Kwang-Mo;Moon, Chang-Woo;Oh, Sin-Geun;Hur, Won-Joo;Lee, Hyung-Sik
    • Radiation Oncology Journal
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    • v.19 no.3
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    • pp.245-251
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    • 2001
  • Prupose : The genes involved on the suppression or radiation-induced apoptosis by genistein in K562 leukemia cell line was investigated. Materials and methods : K562 cells in exponential growth phase were irradiated with a linear accelerator at room temperature. For X-ray irradiation and drug treatment, cultures were prepared at $2\times10^5\;cells/mL$. The cells were irradiated with 10 Gy (Clinac 1800C, Varian, USA), Stock solutions of herbimycin A (HMA, Calbiochem, UK) and genistein (Calbiochem, UK) were prepared in dimethylsulfoxide (DMSO, Sigma, UK). After incubation at $37^{\circ}C$ for 24 h, PCR-select cDNA subtractive hybridization, dot hybridization, DNA sequencing and Northern hybridization were examined. Results : Smad6 gene was identified from the differentially expressed genes in K562 cells incubated with genistein which had been selected by PCR-select cDNA subtractive hybridization. The mRNA expression of Smad6 in K562 cells incubated with genistein was also higher than control group by Northern hybridization analysis. Conclusion : We have shown that Smad6 involved on the suppression of radiation-induced apoptosis by genistein in K562 leukemia cell line. It is plausible that the relationship between Smad6 and the suppression of radiation-induced apoptosis is essential for treatment development based on molecular targeting designed to modify radiation-induced apoptosis.

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A Study on Sod Culture Using Water Foxtail (Alopecurus aegualis var. amurensis) in Apple Orchard (뚝새풀을 이용(利用)한 사과원 초생재배(草生栽培)에 관(關)한 연구(硏究))

  • Jung, J.S.;Lee, J.S.;Choi, C.D.;Cheung, J.D.
    • Korean Journal of Weed Science
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    • v.18 no.2
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    • pp.128-135
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    • 1998
  • The experiment was carried out to obtain basic informations on sod culture using water foxtail in apple orchard at Kyeongbuk Provincial RDA in 1996 to 1997. Period of seedling emergence varied with sowing time and accumulative temperature. Sowing at Nov. 25 required longer than 100 days, while it needed only 8 days when water foxtail was sowed at Sep. 20. In a view of accumulative temperature, sowing at March 15 needed $139^{\circ}C$ but it required about $1,000^{\circ}C$ at August 10. This result showed that the seed of water foxtail has strong summer-dormancy in natural condition. Water foxtail had s-shape growth curve during growing season, and growth rate was the highest from March to May in this period. Plant height increased 2 times and 4 times for dry weight from March 20 to April 20. However, growth was decreased by summer depression after May. Major weeds in apple orchard were horseweed, akino-nogeshi and shepherd's-purse. These species were suppressed by the dominance of water foxtail. Water foxtail as a cover plant could be used for a method of weed control instead of herbicide in apple orchard.

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The Prognostic Effect of Subpleural Lesions in Early Stage Non-small Cell Lung Cancer - Preliminary Report - (초기 비소세포 폐암 환자의 늑막하 병변이 예후에 미치는 영향; 예비 보고)

  • Lee, Ho-Jun;Lee, Hyung-Sik;Hur, Won-Joo;Lee, Ki-Nam;Choi, Pill-Jo
    • Radiation Oncology Journal
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    • v.16 no.4
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    • pp.425-431
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    • 1998
  • Purpose : We retrospectively analyzed the impact of subpleural lesions of early stage non-small cell lung cancer on the patterns of failure to support selection of postoperative adjuvant therapy. Methods and Materials : The study included 91 patients who underwent surgery for early stage non-small cell lung cancer at Dong-A University Hospital from Dec 1990 to Sep 1996. Twenty five patients were excluded due to postoperative mortality (four patients, 4.4$\%$) and stage III (21 patients). Of 66 patients, 22 patients were subpleural lesions (15 patients in stage I, and seven patients in stage II). Postoperative adjuvant radiation therapy was given to seven patients with T2Nl disease. The median follow-up duration was 29.5 months (range; 8-84 months). Results : The overall survival rate was 69.5$\%$ at 3 years. For all patients who presented with (22 patients) and without (44 patients) subpleural lesions, 3-year overall survival rates were 35.5$\%$ and 84.6$\%$, respectively (p=0.0017). For stage I patients who presented with (15 patients) and without (29 patients) subpleural lesions, 3-year overall survival rates were 33.1$\%$ and 92.3$\%$, respectively (p=0.001). For stage II patients who presented with (7 patients) and without (15 patients) subpleural lesions, 3-year overall survival rates were 53.3$\%$ and 45.7$\%$, respectively (p=0.911). For patients with T2N0 disease (34 patients) who presented with (11 patients) and without (23 patients) subpleural lesions, 3-year overall survival rates were 27.3$\%$ and 90.3$\%$, respectively (p=0.009). Conclusion : These observations suggest that the subpleural lesion play an important role as a prognostic factor for early stage non-small cell lung cancer. Especially for T2N0 disease, patients with subpleural lesions showed significantly lower survival rate than those without that.

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A Nutrition Intakes Survey of Pregnant Women in a Urban Area -Application of Convenient Method for the Study of Nutritionial Status- (일개 도시지역 임신부의 영양섭취에 관한 조사연구 -간이식 영양조사법 이용-)

  • Kim, In-Sook
    • Journal of Preventive Medicine and Public Health
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    • v.16 no.1
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    • pp.99-104
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    • 1983
  • Aiming at the total 200 pregnant women including 150 ones registered with the Health Center of Chung Ku District and 50 ones registered with the Health Center of Mapo District, we have conducted a research study of the socio-medical characteristics, maternal child health, and the status of nutritional intake which has utilized the application of convenient method for the study of nutritional status, during the period of April 20 to May 25, 1983. And we have obtained the following conclusions: 1. Regarding age distribution, the pregnant women aged from 26 to 30 were most numerous, which was 54.0%. The percentage of women who experienced the first pregnancy was 12.0% and the percentage of those who experienced the second pregnancy was 37.0%, which was the highest. Regarding the weeks of pregnancy of the pregnant women, the first trimesterr was 11.5%, the second trimester 30.0%, and the third trimester 58.6%. 2. Regarding academic achievements, the pregnant women who graduated from middle schools reached 43.5%, which was the highest percentage. Regarding economic status, the pregnant women who owned their own houses were only 21.0%. And the pregnant women whose monthly income was from 300,000 won to 400,000 won were 40%, which was the most numerous. 5. The women above 15 years old who experienced the first menstruation were 84.0%. And those who experienced abortion were totally 54.4%. and 35.5% among those women experienced artificial abortion. 4. 70.5% of the pregnant women said that their health condition was excellent, 24.5% felt subjective complaints, and 5.0% specially received medical consultation for their diseases. 5. 82.0% received prenatal care, but 60.5% regularly received prenatal care. 68.0% received the education for nutrition and only 19.5% regularly received the education for nutrition. 6. Regarding the family composition, the families consisting of two generations were 47.0%, which was the most numerous. 97.5% of the preparation for meals was conducted by housewives. They said that they did not lack time for meal preparation. 7. 94.9% of the pregnant women said that they had eaten as in ordinary times during their pregnancy. 25.5% said that there were tabooed foods. Tabooed foods are chiefly pork, chicken, milk, and eggs. 68.0% don't drink milk during pregnancy, 32.5% take the intake of vitamins, and 20.5% take iron supplement. 8. The average amounts of the intake of protein, fat, and carbohydrate of a pregnant women are 49.3gm, 29.4gm, and 205.1gm respectively, which showed the phenomenon in which the amount of the intake of nutrition increased as the weeks of pregnancy increased. The average amount of the intake of salt was 14.2gm. 9. Regarding the hemoglobin value of all pregnant women, those whose hemoglobin value was less than 11.0gm were 66.5%, those whose hemoglobin value was 11 to 12 gm were 16.5%. and those whose hemoglobin value was above 12gm were 17.0%. The pregnant women whose hemoglobin value was less than 11.0gm in the first trimester of pregnancy, in the second trimester, and in the trimester were 81.8%, 62.8%, and 64.9% respectively. This shows that the phenomenon of anemia increased as the weeks of pregnancy increased 10. Regarding physical development of a pregnant woman during prenatal period, the height and weight were $156.7cm{\pm}14.1$ and $51.1kg{\pm}58$ respectively. When the standard increase of a prenatal weigt gain is set as 100%, the women over the range of 100% were 28.0% and the women under the range of 80% were 37.0%.

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Predictors of breast-feeding discontinuation in some followed-up hospital-delivered mothers (추적조사된 대구시내 일부 병원분만 산모에서 모유수유중단 예측변수)

  • Lee, Choong-Won;Lee, Moo-Sik;Park, Jong-Won;Lee, Mi-Young;Kang, Mi-Joung;Shin, Dong-Hoon;Lee, Se-Youp
    • Journal of Preventive Medicine and Public Health
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    • v.28 no.4 s.51
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    • pp.845-862
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    • 1995
  • We followed prospectively some hospital-delivered mothers to identify characteristics of those not initiated breast-feeding and predictors of breast-feeding discontinuation in monthly telephone interviews. Recruits were composed of 482 mothers who delivered their babies at one university hospital and one OB/GYN clinic in September to November 1991. Breast-feeding discontinuation was defined as switch to 100% formula lasting more than one week regardless of solid foods. Average age of the study subjects was 27.3 years of age(standard deviation 3.2). Multiple logistic regression analysis indicated native place, occupation, method of delivery and method of feeding considered to be better for maternal health were statistically significant(p<0.1) between initiators and non-initiators of breast feeding. In starting cohort(N=242) of those initiated breast-feeding, that median of breast-feeding discontinuation were 5 months and 25th and 75th percentiles were 3 and 9 months respectively. In Cox's proportional hazard model, mothers with $10\sim13$ years of education were 2.63 times (95% confidence interval, CI $1.50\sim4.60$) more likely to discontinue than those with less than 9 years of education and those with more than 13 years of education were 3.55 time (95% CI $1.99\sim6.33$). Compared with house wife, mothers with part-time jobs were 1.99 times (95% CI $0.86\sim4.57$) more likely to discontinue and those with employed full-time were 1.55 times (95% CI $0.96\sim2.51$). These results suggest that the predictors of initiation and discontinuation of breast-feeding may be different and different target populations should be selected to promote initiation and to prevent discontinuation of breast-feeding according to the period after birth.

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Association of Lifestyle with Blood Pressure (생활양식과 혈압의 관련성)

  • Joo, Ree;Chung, Jong-Hak
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.3 s.58
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    • pp.497-507
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    • 1997
  • This study was conducted to evaluate the association of various lifestyle with blood pressure. The data were obtained from the individuals who got routine health examination in Department of Occupational Medicine, Yeungnam University Hospital from June to September, 1996. Among these people, we selected 130 cases of hypertensives (97 males, 33 females) and 150 normotensives(70 males, 80 females) and study was conducted. The authors collected the information of the risk factors related to hypertension such as age, family history of hypertension, fasting blood sugar, serum total cholesterol, alcohol consumption(g/week), smoking history, relative amount of salt intake (low, moderate, high), the frequency' of weekly meat consumption, BMI, daily coffee consumption(cups/day) and the frequency of regular exercise(frequency/week) through questionnaire and laboratory test. By simple analysis, BMI was significantly associated with hypertension in male(p<0.05), and the frequency of weekly meat consumption was significantly associated with hypertension in female(p<0.05). Using logistic regression model, elevated odds ratio was noted for fasting blood sugar, serum total cholesterol, family history of hypertension, alcohol consumption, salt intake and BMI, and reduced odds ratio was noted for coffee consumption and exercise in male but fasting blood sugar(odds ratio=1.022, 95% CI=1.000-1.044), family history in both of parents(odds ratio=3.301, 95% CI=1.864-4.738), salt intake(odds ratio=1.690, 95% CI=1.082-2.298) and BMI(odds ratio=1.204, 95% CI=1.065-1.343) were statistically significant(p<0.05). In female, elevated odds ratio was noted in serum total choles terol, family history of hypertension, BMI and meat consumption. Of all these variables, the family history of hypertension in either of parents(odds ratio=4.981, 95% CI=3.650-6.312), family history in both of parents(odds ratio=16.864, 95% CI=14.577-19.151), BMI(odds ratio=1.167, 95% CI=1.016-1.318) and meat consumption(odds ratio=2.045, 95% CI=1.133-2.963) showed statistically significant association with hypertension in female(p<0.05).

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