• Journal of Gastric Cancer
• /
• v.9 no.3
• /
• pp.136-142
• /
• 2009

Purpose: This clinical study was conducted to evaluate the predictive value of tumor markers for recurrence and the clinical significance of false positive findings after curative gastrectomy in patients with gastric cancer. Materials and Methods: Two hundred ninety patients with gastric cancer who underwent gastrectomy with curative intent were evaluated retrospectively. We analyzed the correlations between changes in tumor markers (CEA, CA 19-9, AFP, and CA-125) and clinicopathologic data, and basis for changes in tumor markers without recurrence during the follow-up period. Results: The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of tumor markers for recurrence were 75.0%, 64.6%, 23.1%, 94.8%, and 65.9% respectively. Among 36 patients with recurrences, 10 patients (27.8%) had elevated tumor markers prior to positive findings on imaging studies, while 13 patients (36.1%) had concomitant elevation in tumor markers. At least 1 of the 4 tumor markers increased in 90 of 290 patients during the follow-up period; however, there was no evidence of tumor recurrence. Twenty patients had persistently elevated tumor markers, while the tumor marker levels in 70 patients returned to normal level within $9.08\pm7.2$ months. The patients with pulmonary disease, hepatobiliary disease, diabetes, hypertension, or herbal medication users had elevated tumor markers more frequently than patients without disease (P<0.001). Conclusion: Although detecting recurrence of gastric cancer with tumor markers may be useful, false positive findings of tumor markers are common, so surgeons should consider other chronic benign diseases and medical conditions when tumor markers increase without evidence of recurrence.

• Journal of Gastric Cancer
• /
• v.9 no.4
• /
• pp.231-237
• /
• 2009

Purpose: The aim of this study was to evaluate the significance of palliative gastrojejunostomy for treating patients with unresectable stage IV gastric cancer, and as compared with laparotomy for treating patients with incurable gastric cancer. Materials and Methods: We retrospectively studied 167 patients who could not undergo resection without obstruction at Korea University Hospital from 1984 to 2007. They were classified into two groups, one that underwent palliative gastrojejnostomy (the bypass group, n=62) and one that underwent explo-laparotomy (the O&C group, n=105), and the clinical data and operative outcomes were compared according to the groups. Results: For the clinical characteristics, there were no differences of age, gender and liver metastasis between the bypass group and the explo-laparotomy group, but there was a significant different for the presence of peritoneal metastasis (P=0.001). There was no difference between two groups for the postoperative mortality and morbidity. For the postoperative outcomes, the duration of the hospital stay (29.25 vs 16.67) and the frequency of re-admission were not different, but the median overall survival (4.3 months vs. 3.4 months, respectively) was significantly different. By multivariate analysis, the presence of peritoneal metastasis was identified as the independent prognostic factor for incurable gastric cancer. Conclusion: A prophylactic bypass procedure is not effective for improving the quality of life and prolonging the life expectancy of unresectable stage IV gastric cancer patients without obstruction.

• Journal of Gastric Cancer
• /
• v.8 no.1
• /
• pp.27-34
• /
• 2008

Purpose: Many recent studies have reported on the feasibility and usefulness of laparoscopy assisted distal gastrectomy (LADG) for treating early gastric cancer. On the other hand, there has been few reports about laparoscopy assisted total gastrectomy (LATG) because upper located gastric cancer is relatively rare and the surgical technique is more difficult than that for LADG, We now present our procedure and results of performing LATG for the gastric cancer located in the upper or middle portion of the stomach. Materials and Methods: From Jan 2005 to Sep 2007, 96 patients underwent LATG by four surgeons at the Asan Medical Center, Seoul, Korea. Among them, 48 consecutive patients who were operated on by asingle surgeon were analyzed with respect to the clinicopathological features, the surgical results and the postoperative courses with using the prospectively collected laparoscopy surgery data. Results: There was no conversion to open surgery during LATG. For all the reconstructions, Roux-en Y esophago-jejunostomy and D1+beta lymphadenectomy were the standard procedures. The mean operation time was $212{\pm}67$ minutes. The mean total number of retrieved lymph nodes was $28.9{\pm}10.54$ (range: $12{\sim}64$) and all the patients had a clear proximal resection margin in their final pathologic reports. The mean time to passing gas, first oral feeding and discharge from the hospital was 2.98, 3.67 and 7.08 days, respectively. There were 5 surgical complications and 2 non-surgical complications for 5 (10.4%) patients, and there was no mortality. None of the patients needed operation because of complications and they recovered with conservative treatments. The mean operation time remained constant after 20 cases and so a learning curve was present. The morbidity rate was not different between the two periods, but the postoperative course was significantly better after the learning curve. Analysis of the factors contributing to the postoperative morbidity, with using logistic regression analysis, showed that the 8MI is the only contributing factor forpostoperative complications (P=0.029, HR=2.513, 95% CI=1.097-5.755). Conclusions: LATG with regional lymph node dissection for upper and middle early gastric cancer is considered to be a safe, feasible method that showed an excellent postoperative course and acceptable morbidity. BMI should be considered in the patient selection at the beginning period because of the impact of the BMI on the postoperative morbidity.

• The Korean Journal of Elementary Counseling
• /
• v.5 no.1
• /
• pp.65-92
• /
• 2006

The objective of this study is to conduct survey analyses of the role perception and performance of homeroom teachers in elementary schools in Seoul as well as their students' expectations for teachers' role as counsellors. The study also aims to analyze the causes behind the lackluster performance, to provide assistance in teachers' counselling and guidance activities and collect basic data for providing a plausible orientation for elementary school counselling. Research topics for achieving these study objectives are as follows. First, what is the status quo of counselling between elementary school students and teachers? Second, what is the role perception of elementary school homeroom teachers as counsellors and their current level of performance? Third, what are the differences in students' expectations for homeroom teachers' role as counsellors according to students' environmental variables such as gender and grade? Fourth, what are the discrepancies between the roles perception and performance of elementary school homeroom teachers and role expectation of students for homeroom teachers' role as counsellors? In order to answer these questions, surveys were conducted for 229 teachers and 385 students in grades 4, 5 and 6 in 11 elementary schools in Seoul, and the results were analyzed. The questionnaires used for this study were modified and supplemented according to the research objectives based on survey questions released by Gyung-Beom Lee(1989), Hak-Soo Lee(2001) and Gi-Nam Gwon(2005). Statistical analyses were peformed using the SPSS for Windows 10.0 program. The results of the study can be summarized as follows. First, most elementary school homeroom teachers were involved in counselling activities, and about half of them were providing counselling once a month or less. The classroom was the primary location of counselling, and more than half of the surveyed teachers were dissatisfied with their counselling activities. The teachers cited overwhelming teaching hours and excessive work as the factors that made counselling difficult. Second, it was revealed that most elementary school students have had experiences of anguish and most have had some form of counselling. They mostly sought counselling from their parents and friends, and the reasons behind such choices were that they were very understanding. Third, most students responded that they have had no experience of receiving counselling from their homeroom teachers. Among those with counselling experience with their homeroom teachers, most said that the counselling was helpful. The most significant reason for not receiving counselling from their homeroom teachers was that the students had no worries to talk about with their teachers. Fourth, as a result of categorizing the role of elementary school homeroom teachers as counsellors according to the areas of counselling, role perception for each area turned out to be generally high, while performance was substantially lacking. Fifth, in terms of the causes for the lackluster counselling performance, overwhelming teaching hours and excessive work were indicated for counselling areas of academic and personality issues. Sixth, the analysis of students' expectations for elementary school homeroom teachers as counsellors for counselling areas according to gender and grade revealed that there was no overall statistical significance. Seventh, from the general perspective, the level of role perception of the homeroom teachers were higher than the level of students' expectations. In conclusion, in order to enhance the teacher's role as a counsellor, there has to be a concrete perception of roles as a primary premise, calling for training sessions and programs dedicated to counseling for the teachers to take part in. Moreover, in order to alleviate the most significant causes for undermining teachers' counselling activities - overwhelming teaching hours and excessive work - there must be administrative consideration as well as provisions for effective counselling centers and dedicated school counsellors.

• Journal of Korean Society of Occupational and Environmental Hygiene
• /
• v.15 no.1
• /
• pp.71-81
• /
• 2005

The purposes of this study was to collect, analyze, and describe the MF exposure levels from subways in Korea and to measure and evaluate the MF levels generated from electric appliances used at general homes. The target subway lines were Seoul Metropolitan Line 1 to Line 8, Bundang Line, Incheon Line, Daegu Line, Gwangju Line, and Busan Line 1 and Line 2. We measured at each station in those subway lines and, all the train types (pantograph-equipped, motor-equipped, and common), and platform types(facing and isolating) were investigated by the distance(80, 200, 400 cm) from the train on 19 targeted subway lines using 3 magnetic field measuring devices (EMDEXII, Enertech Co.) during the survey from January till October, 2004. On the other hand, the levels of the 60Hz magnetic fields generated from 14 items of home electric appliances such as electric blankets, hair dryers, electric razors, etc. were measured at 10 general homes using 5 EMDEXII meters with a sampling interval of 1.5 second by the distance(surface, 30, 50, 100, 300cm ) from the target electric appliances. The survey results in the whole subway lines examined in this study were as follows; Seoul Metropolitan Line 4 using AC(alternating current) power source showed the highest mean value of $2.85{\mu}T$, followed by Seoul Metropolitan Line 1 running between Seoul and Incheon using AC($2.78{\mu}T$), Seoul Metropolitan Line 1 between Seoul and Uijongbu using AC($2.73{\mu}T$), Bundang Line using AC($1.79{\mu}T$), Seoul Metropolitan Line 1 connected from Yongsan using AC($1.67{\mu}T$), Seoul Metropolitan Line 1 between Seoul and Suwon using AC($0.79{\mu}T$), and so on. In general, the intensity of the magnetic field in the subway systems in Korea was significantly higher when using AC($2.14{\pm}0.91{\mu}T$) than when using DC($0.29{\pm}0.44{\mu}T$) power source. Among the home electric appliances examined, microwave ovens showed the highest mean value of $7.69{\mu}T$, followed by hair dryers($6.47{\mu}T$), vacuum cleaners($5.27{\mu}T$), televisions ($2.26{\mu}T$), electric blankets($1.38{\mu}T$), personal computers ($0.81{\mu}T$), and so on. Two items of electric appliances showed the excess value of $0.2{\mu}T$ at the distance of 30cm in the MF exposure level; electric razors $1.58{\pm}2.13{\mu}T$ and vacuum cleaners $0.48{\pm}0.44{\mu}T$. As a whole, this study showed a tendency that the shift of the MF levels according to the increase of distance from the electric appliances was lower than those of the results surveyed in UK and USA. As a result, this study is expected to suggest meaningful data for the future study in exposure assessment of magnetic fields and for the establishment of guidelines for subways and electric appliances in Korea. More detailed and large scaled exposure assessment studies should be performed continuously to get the various and useful information on health risk assessment of MFs in Korea.

• Journal of the Korean Society of Food Science and Nutrition
• /
• v.33 no.1
• /
• pp.83-90
• /
• 2004

This study was conducted to examine the effects of $\beta$3-adrenergic receptor polymorphism on the blood glucose level and obesity in 530 volunteers, who attended a weight loss program in a local obesity clinic. The age differences in total subjects and the distribution of male and female were 26.55$\pm$0.31 yr, 9.1% (n=48), 90.9% (n=492). The genotype distribution of $\beta$3-AR gene polymorphism were WW type 75%, WR type 22% and RR type 3%. Among many parameters, fasting blood glucose was significantly higher in WR＋RR type (p=0.001) compared with WW type. When the subjects were divided into two groups by 6.105 mmol/L of the fasting blood glucose level, the frequency of hyperglycemia was 23.3% in WW type subjects, while there was a increase to 35.6% in WR＋RR type subjects (p=0.011, $\chi$$^2$-analysis). When hyperglycemia group was compared with normoglycemia group, obesity index (p=0.044), %body fat (p=0.046) and TG (p=0.000) were significantly higher, and HDL (p=0.006) was significantly lower in the hyperglycemia. When all of the above factors were included in stepwise logistic regression analysis to find risk factors of hyperglycemia, the results were that the odds ratio for hyperglycemia were 2.015 (p=0.011) for WR+RR type of $\beta$3-AR gene, 2.165 (p=0.000) for TG and 0.419 (p=0.059) for HDL cholesterol. There was a significantly positive correlation between the blood glucose vs BMI, WHR, body fat in the WW type (r=0.099, 0.119, 0.082) However, in the WR and RR type there were no significance between the blood glucose vs BMI, WHR, body fat. These data suggest that the WR＋RR genotype of $\beta$3-AR has a very strong association with increased blood glucose level and might be a significant risk factor for hyperglycemia among Korean subjects.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.32 no.3
• /
• pp.218-228
• /
• 2010

Components of dental resin-based restorative materials are reported to leach from the filling materials even after polymerization. Hydroquinone (HQ) is one of the major monomers used in the dental resin and is known as a carcinogen. Thus, carcinogenic risk of HQ leaching from the dental resin becomes a public health concern. The present study attempted to examine the carcinogenic potentials of HQ on the human epithelial cell, which is the target cell origin of the most of oral cancers. Cytotoxicity of HQ was observed above 50${\mu}M$ as measured by LDH assay, indicating a relatively low toxicity of this substance in human epithelial cells. The parameters of neoplastic cellular transformation such as cell saturation density, soft agar colony formation and cell aggregation were analyzed to examine the carcinogenic potential of HQ. The study showed that 2-week exposure of HQ showed the tendency of increase in the saturation density and the significant enhancement of soft agar colony formation at the highest dose, 50 ${\mu}M$ only. It is suggested that HQ has a weak potential of carcinogenicity. When cells were treated with HQ and TPA, a well-known tumor promoter, the parameters of neoplastic cellular transformation was significantly increased. This result indicates that the potential risk of carcinogenicity from HQ is largely dependent upon the presence of promoter. Exposure of 50 ${\mu}M$ HQ increased the time-dependent apoptosis as measured by the ELISA kit. This concentration coincides with a dose of neoplastic transformation, indicating a possible link between apoptosis and HQ-induced cellular transformation. Hydroquinone generated Reactive Oxygen Species (ROS) which was evidenced by the treatment of antioxidants such as trolox and N-acetyl cysteine and the GSH depleting agent, BSO. Antioxidants blocked the generation of ROS and the GSH depleting agent, BSO dramatically increased the ROS production. Since HQ is known to increase ROS production thru activation of transcriptional factor such as c-Myb and Pim-1, it is speculated that ROS generation by HQ plays a role in the activation of oncogene, which may lead to neoplastic transformation. In addition, ROS is involved in the alteration of signal transduction, which regulates the apoptosis in many cellular systems. Thus, ROS-mediated apoptosis may be involved in the HQ-induced carcinogenic processes. Protein kinase C (PKC) is known to play pivotal roles in neoplastic transformation of cells and its high expression is often found in a variety of types of tumors including oral cancer. PKC translocation of PKC-${\alpha}$ was observed following HQ exposure. Altered signaling system may also play a role in the transformation process. Taken together, HQ leached from the dental resin does not pose a significant threat as a cancer causing agent, but its carcinogenic potential can be significantly elevated in the presence of promoter. The mechanism of HQ-induced carcinogenesis involved ROS generation, apoptosis and altered signaling pathway. The present study will provide a valuable data to estimate the potential risk of HQ as a carcinogen and understand mechanism of HQ-induced carcinogenesis in human epithelial cells.

• The korean journal of orthodontics
• /
• v.28 no.3 s.68
• /
• pp.353-370
• /
• 1998

This study was conducted to investigate the changes in the structural parts of the craniofacial skeleton subsequent to chincap therapy in the juvenile skeletal Class III patients. The subject consisted of 29 Korean children(14 males, 15 females) who had skeletal Class III malocclusion and were undergone chincap therapy from the beginning of the treatment (and an auxilliary upper removable appliance, if necessary). The control group was composed of 21 children(10 males, 11 females) with skeletal Class III malocclusion who had no orthodontic treatment. Cephalometric data at the mean age of 7 and 2 years later were analyized by finite element method, and compared between groups by independent group t-test(p<0.05). The results of the present study were as follows; 1. There were no significant changes in the cranial base, posterior face, upper anterior face, ramus, chin and soft tissues by the chincap therapy. 2. The mandibular body showed significant differences in the minimum extention ratio and the overall shape ratio. This means that the vertical direction of growth was retarded by the chincap therapy. 3. The major direction of the growth in the maxillary basal bone was significantly more horizontal in the experimental group, which suggests that the vertical growth of maxilla was inhibited. 4. There was statistical difference in the major direction of the growth of the anterior face between groups. This may be due to the significant difference in the major direction of growth of the lower anterior face, supposed to be resulted from the mandibular rotation and/or displacement by the chincap therapy. The change in the oral functional space seemed to be caused by the same reason. 5. From the standpoint of these results, the retardation of growth, the changes of the growth direction and the morphological changes could be accepted partly, but the major effect of the chincap seems to be the rotation and the displacement of the mandible.

• The korean journal of orthodontics
• /
• v.35 no.6 s.113
• /
• pp.475-484
• /
• 2005

This study was performed to investigate the reproducibility of the horizontal and midsagittal planes, and to suggest a stable coordinate system for three-dimensional (3D) cephalometric analysis. Eighteen CT scans were taken and the coordinate system was established using 7 reference points marked by a volume model, with no more than 4 points on the same plane. The 3D landmarks were selected on V works (Cybermed Inc., Seoul, Korea), then exported to V surgery (Cybermed Inc., Seoul, Korea) to calculate the coordinate values. All the landmarks were taken twice with a lapse of 2 weeks. The horizontal and midsagittal planes were constructed and its reproducibility was evaluated. There was no significant difference in the reproducibility of the horizontal reference planes, But, FH planes were more reproducible than other horizontal planes. FH planes showed no difference between the planes constructed with 3 out of 4 points. The angle of intersection made by 2 FH planes, composed of both Po and one Or showed less than $1^{\circ}$ difference. This was identical when 2 FH planes were composed of both Or and one Po. But, the latter cases showed a significantly smaller error. The reproducibility of the midsagittal plane was reliable with an error range of 0.61 to $1.93^{\circ}$ except for 5 establishments (FMS-Nc, Na-Rh, Na-ANS, Rh-ANS, and FR-PNS). The 3D coordinate system may be constructed with 3 planes; the horizontal plane constructed by both Po and right Or; the midsagittal plane perpendicular to the horizontal plane, including the midpoint of the Foramen Spinosum and Nc; and the coronal plane perpendicular to the horizontal and midsagittal planes, including point clinoidale, or sella, or PNS.

• The korean journal of orthodontics
• /
• v.35 no.6 s.113
• /
• pp.409-419
• /
• 2005

Studies for diagnostic analysis using three-dimensional (3D) CT images are recently in progress and needs for 3D craniofacial analysis are increasing in the fields of orthodontics. It is especially essential to analyze the facial soft tissue after orthodontic treatment and orthognathic surgery. In this study 3D CT images of adults with normal occlusion were taken to analyze the facial soft tissue. Norms were obtained from CT images of adults with normal occlusion (12 males, 11 females) using a computer program named V works 4.0 program. 3D coordinate planes were established using soft tissue Nasion as the reference point and a total of 20 reproducible landmarks of facial soft tissue were obtained using the multiple reconstructive sectional images (axial, sagittal and coronal images) of the V works 4.0 program: soft tissue Nasion, Pronasale, Subnasale, Upper lip center, Lower lip center, soft tissue B, soft tissue Pogonion, soft tissue Menton, Endocanthion (Rt/Lt), Alare lateralis (Rt/Lt), Cheilion (Rt/Lt), soft tissue Gonion (Rt/Lt), Tragus (Rt/Lt), and Zygomatic point (Rt/Lt). According to the established landmarks and measuring method, the 3D CT images of adults with normal occlusion were measured and the normal positional measurements and their Net (${\delta}=\sqrt{{X^2}+{Y^2}+{Z^2}}$) values were obtained using V surgery program, In the linear measurement between landmarks, there was a significant difference between males and females except Na' -Sn and En(Rt)-En(Lt). The normal ranges of Na'-Zy, Na'-Ch and Na'-Go' (facial depth) were obtained, which was difficult to measure by two-dimensional (2D) cephalometric analysis and facial photographs. These data may be used as references for 3D diagnosis and treatment planning for patients with malocclusion and dentofacial deformity.