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Causes of Under-staging in Patients with Gastric Cancer That was Proven to be Unresectable after a Laparotomy - Correlation with CT Findings (비절제 위암의 원인분석-전산화단층촬영(CT) 소견을 중심으로)

  • Yoon, Hyuk-Jin;Shin, Jung-Hye;Kim, Gab-Chul;Yu, Wan-Sik;Chung, Ho-Young
    • Journal of Gastric Cancer
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    • v.6 no.4
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    • pp.263-269
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    • 2006
  • Purpose: The aim of this study was to investigate the causes of under-staging in patients with advanced gastric cancer that was proven to be unresectable after a laparotomy. Materials and Methods: We retrospectively analyzed 25 gastric cancer patients who had undergone a diagnostic laparotomy between 2001 and 2005. For the preoperative evaluation, spiral CT and multidetector-row CT were performed. We analyzed the clinicopathologic features of patients and compared the image findings and the results of surgery. The causes of under-staging were divided into 3 groups; patient factor, CT factor, and interpretation factor. Results: Grossly, there were 12 cases of Borrmann type-III tumors and 13 cases of Borrmann type-IV tumors. The most frequent histologic type was poorly differentiated adenocarcinomas (8 cases) and signet ring cell carcinomas (7 cases). There were 13 cases of adjacent organ invasion, and the pancreas was the most frequently invaded organ (9 cases). There were 17 cases of peritoneal metastasis, and 3 cases of distant lymph node metastasis. For the cause of under-staging, there were four cases of patient factor, 19 cases of interpretation factor, and 9 cases of CT factor. In three cases, the cause of under-staging could not be identified. Conclusion: CT interpretation factor was the most frequent cause of under-staging in the preoperative diagnosis with gastric cancer patients. Therefore, more cautious CT interpretation is necessary to avoid unnecessary laparotomies in gastric cancer patients.

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The Surgical Outcome for Gastric Submucosal Tumors: Laparoscopy vs. Open Surgery (위 점막하 종양에 대한 개복 및 복강경 위 절제술의 비교)

  • Lim, Chai-Sun;Lee, Sang-Lim;Park, Jong-Min;Jin, Sung-Ho;Jung, In-Ho;Cho, Young-Kwan;Han, Sang-Uk
    • Journal of Gastric Cancer
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    • v.8 no.4
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    • pp.225-231
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    • 2008
  • Purpose: Laparoscopic gastric resection (LGR) is increasingly being used instead of open gastric resection (OGR) as the standard surgical treatment for gastric submucosal tumors. Yet there are few reports on which technique shows better postoperative outcomes. This study was performed to compare these two treatment modalities for gastric submucosal tumors by evaluating the postoperative outcomes. We also provide an analysis of the learning curve for LGR. Materials and Methods: Between 2003.4 and 2008.8, 103 patients with a gastric submucosal tumor underwent either LGR (N=78) or OGR (n=25). A retrospective review was performed on a prospectively obtained database of 103 patients. We reviewed the data with regard to the operative time, the blood loss during the operation, the time to the first soft diet, the postoperative hospital stay, the tumor size and the tumor location. Results: The clinicopatholgic and tumor characteristics of the patients were similar for both groups. There was no open conversion in the LGR group. The mean operation time and the bleeding loss were not different between the LGR group and the OWR group. The time to first soft diet (3.27 vs. 6.16 days, P<0.001) and the length of the postoperative hospital stay (7.37 vs. 8.88 days, P=0.002) were shorter in the LGR group compared to the OGR group. The tumor size was bigger in the OGR group than that in the LGR group (6.44 vs. 3.65 cm, P<0.001). When performing laparoscopic gastric resection of gastric SMT, the surgeon was able to decrease the operation time and bleeding loss with gaining more experience. We separated the total cases into 3 periods to compare the operation time, the bleeding losses and the complications. The third period showed the shortest operation time, the least bleeding loss and the fewest complications. Conclusion: LGR for treating a gastric submucosal tumor was superior to OGR in terms of the postoperative outcomes. An operator needs some experience to perform a complete laparoscopic gastric resection. Laparoscopic resection could be considered the first-line treatment for gastric submucosal tumors.

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Clinical Usefulness of a Totally Laparoscopic Gastrectomy (전(全)복강경하 위절제술의 임상적 유용성)

  • Kim, Jin-Jo;Kim, Sung-Keun;Jun, Kyong-Hwa;Kang, Han-Chul;Song, Kyo-Young;Chin, Hyung-Min;Kim, Wook;Jeon, Hae-Myung;Park, Cho-Hyun;Park, Seung-Man;Lim, Keun-Woo;Park, Woo-Bae;Kim, Seung-Nam
    • Journal of Gastric Cancer
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    • v.7 no.3
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    • pp.132-138
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    • 2007
  • Purpose: In Korea, the number of laparoscopy-assisted distal gastrectomies for early gastric cancer patients has been on the increase. Although minimally invasive surgery is more beneficial, no reported case of a total laparoscopic gastrectomy has been reported because of difficulty with intracorporeal anastomosis. This study attempts, through our experience, to determine the safety and feasibility of a total laparoscopic gastrectomy with various types of intracorporeal anastomosis using laparoscopic linears stapler in treating early gastric carcinomas. Materials and Methods: We investigated the surgical results and clinicopatholgical characteristics of 81 patients that underwent a totally laparoscopic distal gastrectomy at our department between June 2004 and May 2007. The intracorporeal anastomoses were performed by using laparoscopic linear staplers. Results: The mean operative time was 287 minutes, the mean anastomotic time was 40 minutes, and the mean number of laparoscopic linear staplers used for an operation was 7.5. The mean time to the first flatus, the first food intake, and discharge from hospital was 2.9, 3.6, and 10.3 days respectively. There were 11 cases of postoperative complications, but no case of postoperative mortality or conversion to an open procedure. In 75 patients with an adenocarcinoma, the mean number of lymph nodes harvested was 38.1 and the stage distribution was as follows: stage I, 72 patients; stage II, 2 patients; stage IV, 1 patient. During the mean follow-up period of 14 months, 5 patients died of other causes and there were no cases of cancer recurrence. Conclusion: A total laparoscopic gastrectomy with intracorporeal anastomosis by using a laparoscopic linear stapler was found to be safe and feasible. We were able to obtain acceptable surgical outcomes in terms of minimal invasiveness.

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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.

Effect of Supplementary Radiation on Growth of Greenhouse-Grown Kales (온실재배 케일의 생장에 미치는 보광효과)

  • Heo, Jeong-Wook;Kim, Hyeon-Hwan;Lee, Kwang-Jae;Yoon, Jung-Boem;Lee, Joung-Kwan;Huh, Yoon-Sun;Lee, Ki-Yeol
    • Korean Journal of Environmental Agriculture
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    • v.34 no.1
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    • pp.38-45
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    • 2015
  • BACKGROUND: For commercial production of greenhouse crops under shorter day length condition, supplementary radiation has been usually achieved by the artificial light source with higher electric consumption such as high-pressure sodium, metal halide, or incandescent lamps. Light-Emitting Diodes (LEDs) with several characteristics, however, have been considered as a novel light source for plant production. Effects of supplementary lighting provided by the artificial light sources on growth of Kale seedlings during shorter day length were discussed in this experiment. METHODS AND RESULTS: Kale seedlings were grown under greenhouse under the three wave lamps (3 W), sodium lamps (Na), and red LEDs (peak at 630 nm) during six months, and leaf growth was observed at intervals of about 30 days after light exposure for 6 hours per day at sunrise and sunset. Photosynthetic photon flux (PPF) of supplementary red LEDs on the plant canopy was maintained at 0.1 (RL), 0.6 (RM), and $1.2(RH){\mu}mol/m^2/s$ PPF. PPF in 3 W and Na treatments was measured at $12{\mu}mol/m^2/s$. Natural light (NL) was considered as a control. Leaf fresh weight of the seedlings was more than 100% increased under the 3 W, Na and RH treatment compared to natural light considering as a conventional condition. Sugar synthesis in Kale leaves was significantly promoted by the RM or RH treatment. Leaf yield per $3.3m^2$ exposed by red LEDs of $1.2{\mu}mol/m^2/s$ PPF was 9% and 16% greater than in 3W or Na with a higher PPF, respectively. CONCLUSION: Growth of the leafy Kale seedlings were significantly affected by the supplementary radiation provided by three wave lamp, sodium lamp, and red LEDs with different light intensities during the shorter day length under greenhouse conditions. From this study, it was suggested that the leaf growth and secondary metabolism of Kale seedlings can be controlled by supplementary radiation using red LEDs of $1.2{\mu}mol/m^2/s$ PPF as well as three wave or sodium lamps in the experiment.

Beauty Shop Workers' Views of Job (미용사의 직무만족도와 직업관)

  • Oh, Ai-Ja;Nam, Chul-Hyun
    • The Journal of Korean Society for School & Community Health Education
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    • v.2 no.1
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    • pp.67-84
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    • 2001
  • This study was conducted to examine beauty shop workers' views of job. Data were collected from the workers in Seoul, Daegu, Pohang, Junjoo, and Kimhae from June 1, 2000 to August 31, 2000. The results of this study are summarized as follows. 1. According to general characteristics of the subjects, 28,7% of them was female; 94.2% 'specialized in hair'; 46.4% 'below twenty nine years old'; 47.1% 'married'; 59.7% 'highschool graduate'; 33.9% 'worked for below three years'; 28.5% 'monthly income of five hundred thousand to nine hundred ninety thousand won'; 62.3% 'working for above twelve hours a day' ; 41.0% 'above five workers' ; 40.6% 'working in city'. 2. 54.8% of the respondents thought that they were in good health. 76.3% of them smoked and 54.8% drank. 62.8% of them did not exercise and 78.7% was under stress. 61.5% responded that they chose the job because of its possibility of professional vocation. 91.0% of them obtained the beauty skill from beauty schools. 3. Among the factors which influenced job satisfaction, 'stable job and life security' was highest(43.9%), while 'interest in the job and amount of pay' was lowest(3.2%). 'Personal ability and use of originality' was 19.4% and 'harmonious relationship with fellow workers' was 18.1%. 'Job environment' was 7.1% and 'harmonious relationship with higher workers' was 4.5%. 4. The level workers' view of job was $113.8{\pm}17.3$ points on the basis of 150 points. On the basis of 75 points, each item showed it points in order of self-development($22.3{\pm}3.8$), service for customers($20.1{\pm}3.1$), vocational mission($15.6{\pm}3.1$), harmony with the others($18.9{\pm}3.5$), working environment($18.6{\pm}3.6$), and working condition($14.3{\pm}5.1$). 5. Among the reasons why they considered leaving the job, 24.0% of them considered it because they could not free time, while 15.4% considered it because undesirable living environment or long distance from home. 15.0% thought it because they could not receive proper treatment as much as they worked and 12.8% thought they overworked. 6. When they move into new working places, they consider such factors as good working environment(24.1%), good place to open their own beauty shops(16.7%), good beauty shop to learn beauty skill(15.6%), chance to have job training(9.5%), and close place from home(9.0%). 7. 40.6% of the respondents wanted to leave the job, while 32.3% of them did not want to leave the job. The intention of leaving the displayed significant difference in the variables of age, working period, monthly income, marital status, the number of workers, location of the shop, rank, and reason of selecting the job. 8. According to the results of a regression analysis of factors which influenced job satisfaction, it was affected significantly by intention of leaving job, the number of workers, health condition, level of stress, and monthly income. The beauty shop workers showed low satisfaction level with working environment, working condition, and working mission, They considered leaving the job because of lack of free time, overwork, poor working environment, improper treatment, etc. Therefore, related professionals and organizations must device adequate measures in order to make them work with pride as creators of beauty.

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Studies on electrocardiogram of the normal Korean native cattle I. Standard limb leads (정상적(正常的)인 한우(韓牛)의 심전도(心電圖)에 관(關)한 연구(硏究) I. 표준지유도(標準肢誘導))

  • Choi, In-hyuk;Jung, In-sung;Kim, Nam-soo;Suh, Doo-seok
    • Korean Journal of Veterinary Research
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    • v.33 no.4
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    • pp.719-734
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    • 1993
  • The electrocardiographic(ECG) parameters on the standard limb leads in the normal Korean native cattle have been measured with a 3 channel Electrocardiograph built in a computed analysis. The study was conducted on the animals 98 heads of mean age of 17.7 months. Conduction parameters, waves, intervals and segments have been recorded. The recordings were analyzed as to shape and amplitude of the P and T waves and the components of the QRS complex. Heart rate was recorded by the Electrocardiogram which were a mean of $80.4{\pm}11.6beats/min$. And the younger had a higher heart rate than the older one. Average conduction times in the RP, the QRS complex and the QTc interval recorded $166.7{\pm}23.1msec.$, $79.7{\pm}8.8msec.$ and $395.5{\pm}30.4msec.$, in the P and T wave duration recorded $70.1{\pm}13.5msec.$ and $97.6{\pm}16.9msec.$, and in the PR and ST segment duration recorded $97.9{\pm}23.5msec.$ and $173.9{\pm}40.3msec.$, respectively. The wave forms in each lead observed various types. The amplitudes of wave type showed the highest frequency in each lead that were analyzed as follow : 1. In P wave, amplitudes of the positive type showed the frequency of 65.3%, 82.7% and 52.0% in leads I, II and III that were $103.1{\pm}47.8{\mu}V$, $115.2{\pm}37.3{\mu}V$ and $67.4{\pm}26.9{\mu}V$, and it showed the frequency of 54.1% and 85.7% in the leads aVL and aVF that were $63.7{\pm}23.0{\mu}V$, $88.0{\pm}83.6{\mu}V$, respectively. Average amplitude of the negative type showed the frequency of 78.6% in lead aVR which was $99.3{\pm}38.0{\mu}V$. 2. Average amplitude of the QRS complex were from $362.8{\pm}177.7{\mu}V$ to $532.8{\pm}253.9{\mu}V$(mean of $449.1{\pm}57.2{\mu}V$) that in all leads except lead I were manifested the Low-Voltage QRS complex(below 0.5mV). Average amplitudes of each wave type in the QRS complex aere $-50.2.4{\pm}258.2{\mu}V$ and $-428.6{\pm}195.1{\mu}V$ in the QS groups type that showed a frequency of 66.3%, 70.4% in the leads I and aVL, were $451.1{\pm}20.4.0{\mu}V$, $387.6{\pm}175.8{\mu}V$ and $299.3{\pm}146.5{\mu}V$ in the R groups type that showed a frequency of 48.0%, 53.1% and 34.7% in the leads III, aVR and aVF, and were $-307.5{\pm}180.3{\mu}V$, $201.4{\pm}77.2{\mu}V$ in the QR wave type which showed a frequency of 39.8% in lead II, respectively. 3. In T wave, amplitude of the positive type showed the frequency of 50.0%, 82.7%, 51.0% and 57.1% in leads II, III aVR and aVF which were $214.9{\pm}115.6{\mu}V$, $188.5{\pm}119.3{\mu}V$, $191.0{\pm}93.7{\mu}V$ and $165.7{\pm}91.9{\mu}V$, and the negative type showed a frequecny of 66.3% and 72.5% in leads I and aVL. that were $221.3{\pm}112.5{\mu}V$, $-173.6{\pm}86.7{\mu}V$, respectively. 4. Amplitude of ST segment in leads I, II and III were a mean of $-12.2{\pm}37.2{\mu}V$, $17.5{\pm}42.6{\mu}V$ and $28.3{\pm}40.4{\mu}V$, in leads aVR, aVL and aVF were $-3.9{\pm}32.5{\mu}V$, $-15.9{\pm}35.6{\mu}V$ and $26.2{\pm}37.5{\mu}V$, respectively.

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Study on Morphological Characteristics of Rice Soils in Mangeong-Dongjin and Yeongsan Watersheds (영산강(榮山江)과 만경(萬頃)·동율강유역(東律江流域)의 답토양분포(畓土壤分布)에 관(關)하여)

  • Kim, Han-Myoung;Cho, Guk-Hyun;Yoo, Chul-Hyun;Eun, Mu-Young;Rho, Sung-Pyo;Shin, Yong-Hwa
    • Korean Journal of Soil Science and Fertilizer
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    • v.17 no.2
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    • pp.125-133
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    • 1984
  • To obtain the basic date for the improvement of cultural and managemental problems caused by soil characteristics and soil productivity in rice cultivation of Honam area, morphological characteristics of rice soils were investigated in Mangeng-Dongjin and Yeongsan Water-sheds, and compaired differences between two major Watersheds. The results obtained are summarized as follows: 1. According to U.S.D.A. Soil Taxonomy Classification System, eight great groups are distributed in rice soils of two major Watersheds. More than 50% of rice paddy soils are classified as Haplaquepts. 2. Two Watersheds are quite different in soil parent materials. In Mangeong-Dongjin Watershed, most soils (55.1%) are derived from fluvic-marine deposits. Remainders are derived from local alluvium (24.7%) and alluvium (14.2%). But in Yeongsan Watershed, the order is local alluvium>alluvium>fluvio-marine deposits. 3. Rice soils occur mostly in coastal and inland flat-site with the slope of less than 2% (57.8%) in Mangeong-Dongjin Watersheds. However, in Yeongsan Watershed, flat-site and low undulating terrace are mostly distributed (52.9%). 4. About 81.9, 61.4 and 53.3% of rice soils are classified as fine textured in Yeongsan, Dongjin, and Mangeong Watersheds, respectively. 5. More normal paddy soils and less sandy paddy soils are distributed in Yeongsan Watershed. The results indicate that more rice soils are classified as productivity classes of I and II in Yeongsan Watershed than in Mangeong-Dongjin Watersheds.

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Comparison of Operator Radiation Exposure Dose undergoing Cardiac Angiography and Cardiac Intervention (심장혈관 중재적 시술의 시술자 피폭 선량에 관한 연구)

  • Kim, Jungsu;Kwon, Soonmu;Jung, Haekyoung;Lee, Bongki;Ryu, Dongryeol;Kwon, Hoseok;Cho, Byungryul
    • Journal of the Korean Society of Radiology
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    • v.10 no.3
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    • pp.181-186
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    • 2016
  • Cardiac angiography(CA) or cardiac intervention(CI) is one of the major examination methods applied to the detection of cardiovascular diseases using X-rays. These CA and CI procedures require radiation exposure to patients and physicians. We evaluated the radiation dose to cardiac operator during the each case of CA and CI procedures. The number of patients is 113 patients in CA and 34 patients in CI. Mean fluoroscopy time, mean cine time, and mean total cumulative dose area product(DAP) in patients during CA and CI was 165.9 sec vs. 1200.0 sec, 30.31 sec vs 107.5 sec, and $37130.3mGy.cm^2$ vs $213312.6mGy.cm^2$, respectively. Mean dose of thyroid, over chest apron and under chest apron in operator during CA and CI was 15.84 uSv vs 89.81 uSv, 20.16 uSv vs 123.20 uSv, and 0.30 uSv vs 2.40 uSv, respectively. Mean effective dose of operator during CI was about 6 times greater than during CA. Also there was significant inter-relationship between fluoroscopy or cine time and effective dose in operator during CA and CI(p=0.001 and p=0.001, respectively).

Immunohistoehemical Observation on the Antigens Inducing IgG and IgM Antibodies against Sparganum (IgG와 IgM 항체를 유도하는 sparganum의 항원에 관한 면역조직화학적 및 전기영동에 의한 연구)

  • 김창환;최완성
    • Parasites, Hosts and Diseases
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    • v.29 no.4
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    • pp.339-354
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    • 1991
  • Localization and characterization of the antigenic components of sparganum which induced IgG and IsM antibodies in the host were studied by immunohistochemical techniques and SDS-PAGT and Western blotting. The antigen recognized by IgG antibody of rats or mice which were immunised by infection or injection of crude extracts of metacestodes of Spirometra erinacei, was located in the parenchyme of sparganum, especially at the cortex and around the calcareous corpuscles. The immunoreaction was demonstrated not only in the encysted fibrous wall of host but around the arterioles or venules in the connective tissue of host. The antigen recognized by IgM antibody of rats or mice was also observed in the parenchyme of sparganum and in the connective tissue of host. By 5∼20% gradient SDS-PAGE and EIBT, we detected antigenic components by IgG and 1gG antibodies of the rat or mouse immunized by infection or injection of crude extract of spargana. Twenty-three antigenic bands from crude extracts of spargana were recognized by IgG antibody and 15 components by IgM antibody of immunized rats. Out of the bands recognized by IgG and IgM antibodies, 15 were cross-reacted each other. Twenty components of eBlcretory-secretory proteins from spargana were recognized by IgG, and 5 components by IgM antibody of immunized rats. By IgG and IgM antibodies of immunized mice, 16 components of crude extracts were recognized by IgG antibody and 9 components by IgM antibody. Twenty components of excretory-secretory preparation were recognized by IgG antibody and 5 components by IgM antibody. Thirteen components of crude extracts were cross-reacted by IgG antibody of rats and mice.

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