Background: Mortality and morbidity of anastomotic complications after esophagectomy have gradually decreased in recent years. However, swallowing difficulties and reflux symptoms after esophagogastrostomy continue to be a burden jeopardizing the quality of life. In the present study, we evaluated the quality of esophagogastrostomy by analyzing anastomotic stenosis and reflux esophagitis. Material and Method: A retrospective analysis was made in 74 patients who underwent esophagogastrostomy after esophagectomy by one surgeon between January 1995 and December 2004. 53 patients of them received endoscopic examination during follow-up($29{\pm}23.6$ months, range $5{\sim}111$ months). Reflux esophagitis and stenosis at anastomostic site were analyzed according to the techniques and locations of esophagogastrostomy. Result: The median age at the time of repair was $60.3{\pm}8.87$ years(range $39{\sim}81$ years). 23 patients received a hand-sewn esophagogastric anastomosis and 30 patients a circular stapled one. There was no significant statistical difference in terms of anastomotic stenosis(p=0.64) and reflux esophagitis(p=0.41) between the two groups. Cervical anastomosis was peformed in 26 patients and intrathoracic anastomosis in 27 patients. No significant statistical difference in anastomotic stenosis between the two groups was found(p=0.44), but reflux esophagitis was noted in 3 patients in the cervical anastomosis group and 14 patients in the intrathoracic anastomosis group(p=0.003). Conclusion: Cervical anastomosis was supposed to have a better quality of esophagogastrostomy by lowering the risk of reflux esophagitis. In the future, the comprehensive study including a patient's subjective symptom and Barrett's metaplasia should be performed in larger cases.
KSCE Journal of Civil and Environmental Engineering Research
/
v.36
no.5
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pp.847-856
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2016
Recently, with a high level of economic growth, rapid urbanization, population, environment and housing problems were accompanied in Korea. In particular, the traffic problem has become a serious social problem. As the current transportation policy has been carried out, concentrating on traffic flow, in 2015, death rate for pedestrians while walking (1,795 persons) is 38.8% compared to entire death rate in car accident (4,621 persons), so there is need to solve it. Although, crosswalk should make pedestrian cross it safely, it has been made on the basis of the width of road without exact standard for current width of the crosswalk and the location of stop line. Moreover, in the area around many campuses or commercial facilities, crosswalks are set with not considering pedestrian passage, but designed uniformly. Therefore, the purpose of this study is to estimate reasonable dimension of crosswalk considering pedestrian traffic and walking speed and it makes the accident rate lower in the crosswalk, which has a lot of problems including decisions of vehicle traffic signal time, lack of pedestrian's signal timing, pedestrian's crossing of long-distance. The following are the methodology of the study. Firstly, for crosswalk calculation of specifications, examination relating existing regulations and researches dealing with crosswalk, pedestrians and stop line is needed. After analyzing problems of current width of crosswalk and stop line, present the methodology to calculation of specifications and basing on these things, calculation of specifications for crosswalk will be decided. In conclusion, the calculation of specification and improvement of stop line for crosswalk laid out in this study are expected to be utilized as base data in case of establishing relevant safety facilities and standards.
A survey was conducted to study perception and attitudes of examinees of health screening center towards items, cost and procedures of health examination and degree of satisfaction with health examination, from March 2 to May 31, 1995. The study population was 468 examinees received health examination at Health Screening & Diagnosis Center of Yeungnam University Hospital. A questionnaire method was used to collect data. The followings are summaries of findings : Examinees were predominantly male(77.4%); had college education(68.6%), and held white-collar workers(57.8%). Statistical significance of association between frequency of periodic health examination and other variables were tested by chi-square test. Examinees who have higher degree of concern regarding health and those who practice more exercise for health maintenance received health examination more frequently. The majority expressed that health examination is very beneficial and effective in terms of prevention and early detection of diseases. Also the majority revealed that they are satisfied with health examination. The majority expressed that procedures and time spent for health examination are adequate; interval of health examination is one year; and additional examination items are cerebral examination, neurological examination and gastrofibercope. The majority revealed that they want more information about chronic degenerative diseases and health maintenance and promotion. In conclusion, the study revealed that examinees seemed to have more positive perceptions and attitudes towards health examination.
This experiment was conducted to examine the $PGF{2{\alpha}}$-induced changes in concentrations of ovarian and pituitary hormones of Korean native goats. Each goats received two injections of $PGF{2{\alpha}}$ (5mg each ; 3 hours apart) on day 10 of the estrous cycle. Jugular venous blood samples were collected at 0, 3, 6, 12, 24, 48 and 72 hours postinjection for quantification of LH, FSH, prolactin, progesterone and estradiol-$17{\beta}$. The results were summarized as follows ; The blood serum concentration of progesterone was decreased from pretreatment level of $4.15{\pm}1.8ng/ml$ to $2.52{\pm}1.2ng/ml$ (about 60%) within 3 hours and to $0.81{\pm}0.3ng/ml$ at 12 hours of the $PGF{2{\alpha}}$ injection. After 12 hours, the concentrations of progesterone were less than 1.02ng/ml by 72 hours postinjection. The concentrations of estradiol-$17{\beta}$ following treatment increased (p < 0.05) over the 72 hours. Initial concentration of LH was $3.0{\pm}0.3{\mu}IU/ml$. After treatment with $PGF{2{\alpha}}$, concentrations of LH increased within 12 hours but declined 12 and 72 hours from $4.1{\mu}IU/ml$ to $2.5{\mu}IU/ml$. Prior to administration of $PGF{2{\alpha}}$, mean concentration of FSH was $3.5{\pm}0.5{\mu}IU/ml$. Concentrations of FSH declined over time in goats treated with $PGF{2{\alpha}}$ on day 10 postestrus. The mean prolactin concentrations in the blood serum after $PGF{2{\alpha}}$ treatment were not significantly different from those of the pretreatment. It is concluded that the initial increase in LH is dependent on a decrease in serum progesterone and differences in patterns of secretion of gonadotropins might be caused by differences in progesterone or progesterone-estradiol ratio when luteal regression is induced on day 10 of the estrous cycle.
Purpose : This study evaluated the clinical characteristics of brain tumors in children according to their location, the parental delay and the doctor's delay between the onset of symptoms and the diagnosis of a pediatric brain tumor. In addition, this study compared the relationship between the pre-diagnostic symptomatic interval and the tumor location. Methods : A retrospective study was undertaken of 45 children with primary brain tumors admitted to Inha Hospital from July, 1986 to June, 2004. A diagnosis of the tumor location was made using brain MRI. Results : The male to female ratio was 1 : 0.67. The median age at diagnosis was 6.0 years in supratentorial tumors, 7.0 years in infratentorial tumors. Twenty four cases(53.3 percent) were located in the supratentorial area, 21 cases(46.6 percent) were located in the infratentorial area. The distribution of supratentorial tumors were 14(58.3 percent) in the cerebral hemisphere and temporal lobe, seven (29.1 percent) in the suprasellar area, and three(12.5 percent) in the pineal gland and posterial lateral ventricle. The distributions of the infratentorial tumors were 12(57.1 percent) in the cerebellar vermis and fourth ventricle, four(19.1 percent) in the brain stem, and five(23.8 percent) in the cerebellar hemisphere. The most common initial symptom was seizure(37.5 percent) in the supratentorial tumor and headache(38.0 percent) in infratentorial tumors. The median pre-diagnostic symptomatic interval (PSI) was 21 days(range 0-240 days). The median PSI with a parental delay in supratentorial tumor was six days(range 1-240 days), and 30 days(range 1-40 days) in the infratentorial tumor. We immediately diagnosed most cases after visiting the hospital. There was no significant relationship between the tumor location and the pre-diagnostic symptomatic interval. Conclusion : The most common symptom of supratentorial tumors and infratentorial tumors was seizure and headache, respectively. Although, the median pre-diagnostic symptomatic interval was shorter than in previous studies, a detailed medical history and a correctly interpreted neurological examination should lead to an earlier diagnosis of pediatric brain tumors.
Purpose : This study was performed to assess how a fetal diagnosis of congenital heart disease affects parents, as regards pregnancy management and care of infants after birth. Methods : Database search to find out abnormal fetal echocardiography performed at Seoul National University Children's Hospital from July 1988 to June 2003 revealed 370 examinations. After excluding both arrhythmias without structural cardiac disease and multiple pregnancies, 299 pregnancies remained and this data formed the basis of this analysis. We retrospectively reviewed the medical records with special attention to pregnancy outcomes and also tried to find out factors influencing parental decisions on whether to continue or terminate pregnancy. Results : In this study, the mean gestation age at diagnosis was $28{\pm}6.0weeks$. The mean age of mothers was $30{\pm}3.9$ years old. Younger gestational ages at diagnosis(P=0.000), more severe grades of fetal heart disease(P=0.002) and younger mothers(P=0.014) correlated with terminations of pregnanies. But the grades of fetal status, the grades of associated anomaly, whether in-vitro-fertilization was carried out or not and numbers of previous children were not significant. Conclusion : This study found that the earlier gestational ages at diagnosis, younger maternal age and higher grades of fetal heart disease tended to lead parent to select abortions. Fetal echocardiographies were performed too late. Moreover Koreans have a biased view that malformation is a something incurable and a tragedy not only to oneself, but also to a family. So parents select terminations of pregnancy, even in curable cases. This is very unethical.
Kim, Jum Su;Yang, Jung Soo;Jung, Hae Sung;Lee, Min Hye;Park, Chan-Hoo;Choi, Myoung Bum;Woo, Hyang-Ok;Youn, Hee-Shang
Clinical and Experimental Pediatrics
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v.45
no.4
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pp.459-465
/
2002
Purpose : The aim of this study was to evaluate the latest tendency of esophageal foreign body's extraction and to obtain a consensus from recent trends of indications and techniques of flexible endoscopy of esophageal FB in children. Methods : We retrospectively reviewed medical records of 127 cases with foreign bodies in esophagus at Dept. of Pediatrics and Otorhinolaryngology, Gyeongsang National University Hospital (GNUH) from Jun, 1987 to July, 2001. They were divided into two groups by the kinds of endoscopy : flexible endoscope(66 cases) or rigid endoscope(61 cases). Rigid endoscopy was performed under general anesthesia at Dept. of Otorhinolaryngology but flexible endoscopy was performed without general anesthesia or sedative drugs(midazolam or diazepam). Results : An annual number of cases of two groups were similar from 1991 to 1998. But from 1999, flexible endoscopy was performed actively. Asymptomatic cases were frequently observed in flexible endoscopy(28 cases/66 cases) but swallowing difficulties were frequently observed in the rigid endoscopy group(25 cases/61 cases). Other symptoms were vomiting, irritability, chest discomfort and abdominal pain. The total number of cases with underlying disease(esophageal stenosis, cerebral palsy) was 8. The total number of cases with complications (erosion, ulcer, bleeding, perforation) was 11. The above cases were not correlated between the two groups. In 55 cases(83.3%) of the flexible endoscopic group and 53 cases(86.8%) of the rigid endoscopic group, foreign bodies in the esophagus were removed within 24 hours. Conclusion : We could not find any benefit in rigid endoscopic technique. Flexible endoscopic FB removal can be performed safely and effectively in children by an experienced endoscopist.
Kim, Myung Hyun;Kim, Jung Hee;Lim, Dae Hyun;Son, Byong Kwan;Lee, Kyung-Hee
Clinical and Experimental Pediatrics
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v.45
no.3
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pp.339-345
/
2002
Purpose : The purpose of this study was to evaluate the clinical usefulness of chest high-resolution computed tomography(HRCT) in patients with chronic coughs or persistent wheezing with normal chest X-ray finding. Methods : We reviewed the charts, chest X-rays, and HRCT findings of patients with chronic coughs or persistent wheezing of less than 2 years of age. The records were sourced from the Department of Pediatrics, Inha University Hospital covering the period from July, 1999 to June, 2000. Chronic cough was defined as a cough which was prolonged for more than 3 weeks. Results : The sample consisted of 24 patients(male 15 and female 9, mean age $4.7{\pm}3.8$ months old). Among them, 16 patients showed normal findings(66.7%) and 8 patients showed abnormal (33.3%) in simple chest X-rays. Among 16 patients who had the normal chest X-rays, 13 patients showed abnormal chest HRCT findings(81.3%) such as air space consolidation of the dependent portion(62.5%), bronchiolitis obliterans(12.5%), and bronchopulmonary dysplasia(6.3%). Conclusion : We suggest that the chest HRCT is a useful diagnostic tool in the evaluation of patients with chronic cough or persistent wheezing with normal chest X-ray, especially below 2 years of age.
Kim, Kyoung-Ok;Park, Hyunjin;Chun, Mison;Lee, Eun Hyun;Kim, Hyun-Sook
Journal of Nutrition and Health
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v.46
no.3
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pp.250-260
/
2013
The purposes of this study were 1) to investigate eating behaviors and patterns in breast cancer patients using a newly developed food frequency questionnaire and 2) to examine perception and use of nutritional information about breast cancer treatment among cancer patients treated with radiation therapy. Sixty breast cancer patients (case group) undergoing radiation therapy in Ajou University Hospital, Suwon, South Korea and 79 healthy women (control group) participated in this study. Mean age of subjects in the control group was $46.00{\pm}7.88$ years and BMI was $23.12{\pm}2.85kg/m^2$, and that of the case group was $50.06{\pm}11.64$ years and $22.32{\pm}3.24kg/m^2$. The results of eating behaviors showed several significant differences between control and case groups. Breast cancer patients ate meals on a more regular basis, on time, and more frequently compared to control subjects. In addition, they preferred more salty or spicy and bland food compared to healthy women. According to answers from the food frequency questionnaire, breast cancer patients consumed significantly lower amounts of boiled white rice, meats and processed food, fish and shellfish, coffee, milk, and cheese, whereas they consumed a significantly large amount of boiled multigrain rice, vegetable, seaweeds, soybean and processed food, and yoghurt compared to healthy women. This study also observed the way in which cancer patients and healthy control subjects obtain information about breast cancer treatment and its reliabilities. Results showed that healthy women did not hesitate to obtain information from mass media, while breast cancer patients would obtain nutritional information from specialists rather than mass media. Results of this survey confirmed that breast cancer patients avoided intake of red meat protein, even though they already recognized the importance of dietary protein intake for recuperation and treatment of the disease. These results could be used for future diet and nutrition guidelines for breast cancer patients.
Purpose : Brain metastases are the most frequent metastatic neurologic complication of systemic cancer. Even if the prognosis of brain metastases is grave, with available treatments, most patients experience effective palliation of neurologic symptoms and meaningful extension of life. We evaluated the clinical features and prognostic factors of the patients who were diagnosed as solid tumors with brain metastasis and received radiotherapy for brain metastases. Materials and Methods: Between January 1987 and January 1998, 71 patients with brain metastases from solid malignancy were included. We reviewed neurologic symptoms and signs of patients and evaluated improvememt of neurologic symptoms and signs. Survival durations after brain metastasis were ana lysed according to several factors such as age, performance status, primary malignancies, the pre-sence of brain metastasis at initial diagnosis of primary tumor, multiplicity of brain metastass, the presence of metastases other than brain, and treatment method. Results: Frequent symptoms associated with brain metastasis were headache (47.9$\%$), motor weakness (40.8$\%$), nausea and vomiting (19.7$\%$) and mental change (19.7%). Palliation of these symptoms was accomplished in 64.9$\%$ of cases. The overall median survival time was 16 weeks and 1- and 2-year survival rates were 15.0$\%$ and 5.1$\%$ respectively. Patients without extracranial metastases (n=27) had longer median survival than patients with extracranial metastases (33 weeks vs 10 weeks, p=0.0018). In patients with single brain metastasis (n=37), the median survival time was longer in patients treated with surgery plus radiotherapy than in patients treated with radiotherapy alone (40 weeks vs 16 weeks, p=0.0438). Conclusion: Patients who has brain metastases only constitute a prognostically favorable group and they may be benefited from radiotherapy and surgery if indicated.
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