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Laparoscopy-assisted Total Gastrectomy for Advanced Upper Gastric Cancer - Comparison with Open Total Gastrectomy - (진행위암의 복강경 보조 위 전절제술 - 개복 위 전절제술과의 후향적 비교 -)

  • Lee, Jun Hyun;Nam, Yoo Hee;Hur, Hoon;Jeon, Hae Myung;Kim, Wook
    • Journal of Gastric Cancer
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    • v.8 no.3
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    • pp.141-147
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    • 2008
  • Purpose: The aim of this study was to compare the short-term operative outcomes of laparoscopy-assisted total gastrectomy (LATG) with those of open total gastrectomy (OTG) for patients suffering with advanced upper gastric cancer. Materials and Methods: Of the 47 patients who underwent LATG with $D1+{\beta}$ or D2 lymphadenectomy from July 2004 to March 2008, 29 patients with pathologically proven advanced gastric cancer were compared with 35 patients who underwent conventional OTG during the same time period. The comparison was based on the clinicopathological characteristics, the surgical outcome, the follow-up survival and tumor recurrence. Results: The patients' age, gender and body mass index were similar between the two groups. However, there were statistically differences in tumor size ($9.2{\pm}3.9$ vs $6.1{\pm}3.6cm$, P=0.002) and the proximal resected margin ($2.1{\pm}2.0$ vs $3.6{\pm}2.1cm$ P=0.004). There was no significant difference in most of the peri- and post-operative courses such as the time to first flatus, the time to starting a solid diet and the length of the hospital stay, except for a longer operating time (289.0 vs. 361.3 minutes, P<0.001) in the LATG group. The complication rate was higher in the LATG group (13.8%) than that in the OTG group (5.7%). The mean overall survival and disease free survival times were 32 and 31 months, and 24 and 28 months, respectively, with an average 18.8 months follow-up duration. The main recurrent sites were peritoneum and lymph node in both groups. Conclusion: The early results of the current study suggest that LATG for AGC is technically feasible and it does not show any inferiorities of the postoperative outcomes as compared to those of conventional open total gastrectomy.

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The Optimization of Reconstruction Method Reducing Partial Volume Effect in PET/CT 3D Image Acquisition (PET/CT 3차원 영상 획득에서 부분용적효과 감소를 위한 재구성법의 최적화)

  • Hong, Gun-Chul;Park, Sun-Myung;Kwak, In-Suk;Lee, Hyuk;Choi, Choon-Ki;Seok, Jae-Dong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.1
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    • pp.13-17
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    • 2010
  • Purpose: Partial volume effect (PVE) is the phenomenon to lower the accuracy of image due to low estimate, which is to occur from PET/CT 3D image acquisition. The more resolution is declined and the lesion is small, the more it causes a big error. So that it can influence the test result. Studied the optimum image reconstruction method by using variation of parameter, which can influence the PVE. Materials and Methods: It acquires the image in each size spheres which is injected $^{18}F$-FDG to hot site and background in the ratio 4:1 for 10 minutes by using NEMA 2001 IEC phantom in GE Discovey STE 16. The iterative reconstruction is used and gives variety to iteration 2-50 times, subset number 1-56. The analysis's fixed region of interest in detail part of image and compute % difference and signal to noise ratio (SNR) using $SUV_{max}$. Results: It's measured that $SUV_{max}$ of 10 mm spheres, which is changed subset number to 2, 5, 8, 20, 56 in fixed iteration to times, SNR is indicated 0.19, 0.30, 0.40, 0.48, 0.45. As well as each sphere's of total SNR is measured 2.73, 3.38, 3.64, 3.63, 3.38. Conclusion: In iteration 6th to 20th, it indicates similar value in % difference and SNR ($3.47{\pm}0.09$). Over 20th, it increases the phenomenon, which is placed low value on $SUV_{max}$ through the influence of noise. In addition, the identical iteration, it indicates that SNR is high value in 8th to 20th in variation of subset number. Therefore, to reduce partial volume effect of small lesion, it can be declined the partial volume effect in iteration 6 times, subset number 8~20 times, considering reconstruction time.

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Comparison of Acute Clinical Features and Coronary Involvement in Patients with Kawasaki Disease between Those Younger and Older than One Year of Age (1세 미만과 1세 이상의 가와사끼병 환아에서 급성기 임상양상 및 관상동맥 변화에 대한 비교)

  • Kim, So Young;Lim, Seong Joon;Yun, Sin Weon;Lee, Dong Keun;Choi, Eung Sang
    • Clinical and Experimental Pediatrics
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    • v.45 no.6
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    • pp.773-782
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    • 2002
  • Purpose : To identify the necessity of more reasonable diagnostic criteria and the possibility of early prediction of coronary involvement in the higher risk group, we investigated and compared clinical and laboratory findings in the acute phase and coronary involvements in those younger (n=17) and older(n=53) than one year of age in Kawasaki disease(KD). Methods : Retrospective chart reviews were performed on 70 patients with KD who were admitted to the Chung-Ang University Hospital from April 1997 to May 2001. Results : Male were significantly higher in the younger age group(M : F ratio 3.3 : 1 vs. 1.0 : 1, P=0.004). Fever durations before intravenous immunoglobulin(IVIG) and echocardiography were significantly shorter in the younger group($4.6{\pm}1.3$ vs. $6.2{\pm}2.5$, P=0.004 vs. 0.01, respectively). Cases meeting typical diagnostic criteria were significantly less in the younger group(P=0.006). In the laboratory findings, serum albumin, BUN and $K^+$ levels in the acute febrile phase were significantly higher in the younger group(P=0.002, 0.006, <0.001, respectively) and incidences of coronary artery dilatation in the acute phase were significantly higher in the younger group(P=0.01). Conclusion : Although less met the typical diagnostic criteria of KD, infants younger than one year of age are more susceptible to coronary artery change in the acute febrile phase. Therefore, KD should be entertained as a diagnostic possibility in young infants with prolonged fever without distinct fever focus, and echocardiography should be considered as part of the evaluation of these patients, and then early diagnosis and prompt IVIG should be conducted.

The detection of collapsible airways contributing to airflow limitation (기류 제한에 영향을 미치는 허탈성 기도의 분석)

  • Kim, Yun Seong;Park, Byung Gyu;Lee, Kyong In;Son, Seok Man;Lee, Hyo Jin;Lee, Min Ki;Son, Choon Hee;Park, Soon Kew
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.4
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    • pp.558-570
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    • 1996
  • Background : The detection of Collapsible airways has important therapeutic implications in chronic airway disease and bronchial asthma. The distinction of a purely collapsible airways disease from that of asthma is important because the treatment of the dormer may include the use of pursed lip breathing or nasal positive pressure ventilation whereas in the latter, pharmacologic approaches are used. One form of irreversible airflow limitation is collapsible airways, which has been shown to be a Component of asthma or to emphysema, it can be assessed by the volume difference between what exits the lung as determined by a spirometer and the volume compressed as measured by the plethysmography. Method : To investigate whether volume difference between slow and forced vital Capacity(SVC-FVC) by spirometry may be used as a surrogate index of airway collapse, we examined pulmonary function parameters before and after bronchodilator agent inhalation by spirometry and body plethysmography in 20 cases of patients with evidence of airflow limitation(chronic obstructive pulmonary disease 12 cases, stable bronchial asthma 7 cases, combined chronic obstructive pulmonary disease with asthma 1 case) and 20 cases of normal subjects without evidence of airflow limitation referred to the Pusan National University Hospital pulmonary function laboratory from January 1995 to July 1995 prospectively. Results : 1) Average and standard deviation of age, height, weight of patients with airflow limitation was $58.3{\pm}7.24$(yr), $166{\pm}8.0$(cm), $59.0{\pm}9.9$(kg) and those of normal subjects was $56.3{\pm}12.47$(yr), $165.9{\pm}6.9$(cm), $64.4{\pm}10.4$(kg), respectively. The differences of physical characteristics of both group were not significant statistically and male to female ratio was 14:6 in both groups. 2) The difference between slow vital capacity and forced vital capacity was $395{\pm}317ml$ in patients group and $154{\pm}176ml$ in normal group and there was statistically significance between two groups(p<0.05). Sensitivity and specificity were most higher when the cut-off value was 208ml. 3) After bronchodilator inhalation, reversible airway obstructions were shown in 16 cases of patients group, 7 cases of control group(p<0.05) by spirometry or body plethysmography d the differences of slow vital capacity and forced vital capacity in bronchodilator response group and nonresponse group were $300.4{\pm}306ml$, $144.7{\pm}180ml$ and this difference was statistically significant. 4) The difference between slow vital capacity and forced vital capacity before bronchodilator inhalation was correlated with airway resistance before bronchodilator(r=0.307 p=0.05), and the difference between slow vital capacity and forced vital capacity after bronchodilator was correlated with difference between slow vital capacity and forced vital capacity(r=0.559 p=0.0002), thoracic gas volume(r=0.488 p=0.002) before bronchodilator and airway resistance(r=0.583 p=0.0001), thoracic gas volume(r=0.375 p=0.0170) after bronchodilator, respectively. 5) The difference between slow vital capacity and forced vital capacity in smokers and nonsmokers was $257.5{\pm}303ml$, $277.5{\pm}276ml$, respectively and this difference did not reach statistical significance(p>0.05). Conclusion : The difference between slow vital capacity and forced vital capacity by spirometry may be useful for the detection of collapsible airway and may help decision making of therapeutic plans.

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Gender Difference in Quality of Life After Controlling for Related Factors among Korean Young-old and Old-old Elderly (한국 전·후기 노인의 삶의 질 관련요인과 성별 차이)

  • Chung, Younghae;Cho, Yoo Hyang
    • Journal of agricultural medicine and community health
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    • v.39 no.3
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    • pp.176-186
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    • 2014
  • Objectives: As a sequel to the former analysis of the quality of life (QoL) among young-old and old-old in Korea, this research was aimed to identify factors related to the quality of life and the gender difference after controlling for the related factors among Korean elderly. Methods: Selected elderly data of 1,339 subjects from the 5th Korea National Health and Nutrition Examination Survey conducted in 2010 was analyzed. In this survey, QoL was measured using Euro Quality of Life (EQ-5D) instrument. Data were analyzed using complex survey data analysis on IBM-SPSS 20.0. The related factors were identified using general linear models with backward elimination. The gender difference was tested also using general linear models. Results: The distributions of educational level, family income level, and presence of cohabitant were different between male and female elderly in both young-old and old-old age group. So were the health behaviors and perceived health, and experience of stress, depression, and suicidal thoughts. QoL and its subscales- mobility, self care, daily living, pain and discomfort, and anxiety and depression- were consistently better among male elderly regardless of age group. Among the variables considered, education, family income level, presence of cohabitant, perceived health, age group and BMI were found to be related to the QoL at p=.05, and presence of chronic diseases at p=.10. The difference in QoL between male and female elderly after controlling for the variables was statistically significant. Conclusion: Improving QoL is particularly important for the elderly. In order to improve QoL of the elderly, age- and gender- differences need to be considered when developing services and programs for the elderly.

Effect of Waste Nutrient Solution and Fertigation Nutrient Solution on the Growth and Qualities of Tomato Grown by Fertigation (관비재배시 토마토 생육과 품질에 미치는 폐양액과 기존 비료의 효과)

  • Zhang, Cheng Hao;Xu, Zhihao;Kang, Ho-Min;Kim, Il-Seop
    • Horticultural Science & Technology
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    • v.28 no.4
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    • pp.574-579
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    • 2010
  • Waste nutrient solution (WNS) that was the drained nutrient solution of Horticultural Research Institute of Japan for culture tomato in perlite hydroponics showed $1.9-2.4dS{\cdot}m^{-1}$ of EC and 5.7-7.1 pH from April to July. Although ${NH_4}^+-N$ concentration of WNS decreased remarkably, the other nutrients did not change significantly, as compared with supplied solution. There were no significant differences in plant height, stem diameter, and the other growth characteristics of tomato plants grown by 2 fertigation nutrient solutions; BHF (Bountiful Harvest Fertilizer, 10% of N, 13% of $PO_4$, 13% of K, 0.05% of B, 0.05% of Zn, and 0.0023% of Cu that made in Korea) and Megasol (11% of N, 8% of $PO_4$, 34% of K, 0.032% of Mn, 0.002% of B, 0.048% of Fe, 0.0122% of Zn, and 0.0023% of Cu that made in Belgium.); however, the chlorophyll content of tomato leaf was highest in WNS. The fresh and dry weight of tomato plants were higher in 3 fertigation treatments than irrigation of tap water, while there were no significant differences in fresh and dry weight among the 3 fertigation treatments. The mineral content of tomato leaf also did not show any differences among the 3 fertigation treatments and any regular tendency in all minerals. Total yield, fruit weight and fruit numbers of tomato were higher in WNS, followed by Megasol, BHF and control, although there were not any difference among the 3 fertigation nutrient solution treatments. BER(blossom-end rot)of tomato fruits decreased in fertigation treatments, especially, fruits grown in WNS and BHF showed lower BER. However, the transpiration rate of leaf was higher in control, followed by BHF, WNS and Megasol, The fruit size and soluble solids content was higher in 3 fertigation nutrient treatments than control. These results suggest that WNS can be used for fertigation solution in tomato because yield and quality of tomato fruit grown in WNS fertigation treatment were similar to those in 2 fertigation nutrient solutions treatments(BHF, Megasol).

Effects of Dietary Barley on the Growth Performance and Carcass Characteristics in Hanwoo Steers (보리의 사료가치평가와 한우 거세우 급여에 의한 발육 및 육질개선효과 구명)

  • Chang, S.S.;Oh, Y.K.;Kim, K.H.;Hong, S.K.;Kwon, E.G.;Cho, Y.M.;Cho, W.M.;Eun, J.S.;Lee, S.C.;Choi, S.H.;Song, M.K.
    • Journal of Animal Science and Technology
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    • v.49 no.6
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    • pp.801-818
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    • 2007
  • This study was carried out to determine the effects of processing methods of barley as a proper source of grain in diets of Hanwoo on fermentation pattern in the rumen fluid and digestibility of the diets, the growth performance and carcass characteristics of Hanwoo. The degree of ruminal pH change in the cows fed diets of the Corn(corn basis) and GDRB(ground and dry-rolled barley) tended to be greater than those in the cows fed other two diets (ground barley, GB and dry-rolled barley, DRB). The diet of GDRB showed the lowest ruminal pH(5.5), indicating the rapid degradation of the diet in the rumen. Although ammonia concentration was not affected by diet, the GR and DBR diets maintained the low concentrations of ruminal ammonia compared with other two treatments. And the effects of feeding processed barley grain on body weight gain and meat quality of Hanwoo steers were as follows. Steers fed DRB diet had the highest body weight, 683.0kg at 28 months old, while those fed the GDRB showed the lowest body weight, 653.3kg. The average daily gain(ADG) was similar between the steers fed Corn and GR throughout the whole period, but the GDRB showed the lowest ADG. The steers fed the DRB showed the significant increase in ADG(0.89kg/d from 19 to 23 months old and 0.43kg/d from 24 to 28 months old) compared with those fed other diets. Feeding diets containing corn and/or barley did not influence live body weight, cold carcass weight, carcass yield, back-fat thickness and carcass grade of Hanwoo steers.

Dosimetric Advantages of the Field-in-field Plan Compared with the Tangential Wedged Beams Plan for Whole-breast Irradiation (유방암 환자의 방사선치료에 있어서 순치료계획 세기변조방사선치료법과 쐐기접선조사기법의 선량측정 비교)

  • Kim, Suzy;Choi, Yunseok
    • Progress in Medical Physics
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    • v.25 no.4
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    • pp.199-204
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    • 2014
  • The purpose of this study is to evaluate the dosimetric outcome of the field-in-field (FIF) plans compared with tangential wedged beams (TWB) plans for whole breast irradiation of breast cancer patients. Twenty patients with right-sided breast cancer and 10 patients with left-sided breast cancer were retrospectively enrolled in this study. We generated a FIF plan and a TWB plan for each patient to compare dosimetric outcomes. The dose the homogeneity index (HI), the conformity index (CI) and the uniformity index (UI) were defined and used for comparison of the dosimetric outcome of the planning target volume (PTV). To compare the dosimetric outcome of the organs at risk, the mean dose ($D_{mean}$) and the percentage of volumes receiving more than 10, 20 and 30 Gy of the ipsilateral lung and heart were used. The FIF plans had significantly lower HI (p=0.002), higher UI (p=0.000) and CI (p=0.000) than those of the TWB plans, which means that the FIF plans were better than the TWB plans in the dosimetric comparisons of the PTV. The $V10_{lung}$ ($17.1{\pm}7.1$ vs. $18.6{\pm}6.6%$, p=0.020) and $V30_{lung}$ ($10.3{\pm}5.1%$ vs. $10.7{\pm}5.2%$, p=0.000) were lower with the FIF plans compared with those of the TWB plans, with statistical significance. For the left-sided breast cancer patients, $D_{mean}$ of the heart ($2.6{\pm}1.3$ vs. $3.2{\pm}1.4$ Gy, p=0.000), $V20_{heart}$ ($3.4{\pm}2.6$ vs. $3.6{\pm}2.8%$, p=0.005) and $V30_{heart}$ ($2.6{\pm}2.3%$ vs. $2.9{\pm}2.4%$, p=0.004) were significantly lower for the FIF plans in comparison with those of the TWB plans. The FIF plans increased the dose homogeneity, conformity and uniformity of the target volume for the whole-breast irradiation compared with the TWB plans. Moreover, FIF plans reduced the doses to the ipsilateral lung and heart.

A Study on Personalized Product Demand Manufactured by Smart Factory (스마트팩토리 환경의 개인맞춤형 제품 구매의도의 영향요인에 관한 연구)

  • Woo, Su-Han;Kwon, Sun-Dong
    • Management & Information Systems Review
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    • v.38 no.1
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    • pp.23-41
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    • 2019
  • Smart Factory is different from existing factory automation in that it aims to produce personalized products with minimum time and cost through ICT. However, previous researches, not from consumers but from product suppliers, have focused on technology trends and technology application methods. In order for Smart Factory to be successful, it must go beyond supplier-focus to meet the needs of consumers. In this study, we surveyed the purchase intention of the personalized product manufactured by smart factory. Influencing factors of purchase intention were drawn as consumers' need for uniqueness, innovativeness, need for touch, and privacy concern, based on previous research. As results of data analysis, it was confirmed that respondents were willing to purchase personalized products, and that consumers' need for uniqueness, innovativeness, and need for touch had a significant impact on purchase intention of personalized products. Our findings can be summarized as follows. First, Consumers' need for uniqueness was found to have positive effects(${\beta}=0.168$) on purchase intention of personalized products. The desire to differentiate themselves from others will be reflected in their personalized products. Therefore, consumers with a higher desire for uniqueness tend to be more willing to purchase personalized products. Second, consumer innovativeness was found to have positive effects(${\beta}=0.233$) on purchase intention of personalized products. Personalized shoes suggested in this study is a new type of personalized product that is manufactured by the latest information and communication technologies such as multi-function robots and 3D printing. Therefore, consumers seeking innovative new experiences are more willing to purchase personalized products. Third, need for touch was found to have positive effects(${\beta}=0.299$) on purchase intention of personalized products. In a smart factory environment, prosuming participation is given to consumers. If consumers participate in the product development process and reflect their requirements on the product, they are expected to increase their purchase intention by virtually satisfying the need for touch. Fourth, privacy concern was found to have no significantly related to purchase intention of personalized products. This is interpreted as a willingness to tolerate the risk of exposing personal information such as home address, telephone number, body size, and preference for consumers who feel highly useful in personalized products.

The Prevalence of Obesity and Underweight in Adolescents in Incheon Area and the Relationship between Serum Cholesterol Level and Obesity (인천지역 청소년의 비만도와 혈청 콜레스테롤치와의 관계)

  • Kim, Myung Hyun;Kim, Tae Wan;Hong, Young Jin;Son, Byong Kwan;Pai, Soo Hwan;Chang, Kyung Ja;Kim, Soon Ki
    • Clinical and Experimental Pediatrics
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    • v.45 no.2
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    • pp.174-182
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    • 2002
  • Purpose : The purpose of this study was to investigate the prevalence of obese and underweight adolescents in Incheon area and to examine the relationship between serum cholesterol level and obesity, then to assess the nutritional condition of adolescents. Methods : With a questionnaire regarding their demographic characteristics, blood samples were obtained from apparently healthy students aged 12 to 24 years by venipuncture at April and May, 2000. We measured the obesity index using standard body weight and the body mass index(BMI) according to the criteria established by the Korean Pediatric Society in 1998. Obesity was defined as BMI more than 95 percentile, and underweight less than 15 percentile by age and sex. Results : A total of 1,456 students(M : F=685 : 771) aged 12 to 24 years were included in this study. The prevalence of obesity by standard body weight in adolescents in Incheon were 11.7% : mild obesity 6.5%, moderate 4.6%, and severe 0.5%. By BMI, the prevalence of obesity was 6.4% in males and 6.2% in females. In males, the prevalence of obesity in rural areas was 8.5%, lower than in urban areas(14.3%). The prevalence of underweight by obesity index was 34.1% in rural areas and 22.9% in urban areas. In females, the prevalence of obesity was 12.5% in rural areas and 19.6% in urban areas. There were no significant differences between the two regions(P=0.529). The prevalence of obesity increased with age till 16.3% of peak prevalence in 16 years of age, and then decreased. In males, the prevalence of obesity in academic and vocational school were 13.7% and 9.7%, respectively(P=0.116). In females of the academic and vocational school, the prevalence of obesity was 6.8% and 18.0%, respectively(P=0.001). In obese adolescents, serum total cholesterol was over 200 mg/dL in 6.2%. Conclusion : This study revealed that the prevalence of obesity in adolescents was about 12% and that the prevalence of underweight adolescents was considerably high. We think nutritional assessment and intervention are warranted for adolescent students.