• Title/Summary/Keyword: Intake food

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Correlation between the Serum Leptin Level and the Expression of Leptin in Stomach Cancer Patients (위암에서 혈청 렙틴 레벨과 조직 내 렙틴 발현과의 상관관계)

  • Kim, Ji-Hyun;Jung, Hun;Jun, Kyong-Hwa;Kim, Sung-Keun;Chin, Hyung-Min;Jung, Ji-Han;Kim, Wook;Jeon, Hae-Myung;Park, Cho-Hyun;Park, Seung-Man;Park, Woo-Bae;Lim, Keun-Woo;Kim, Seung-Nam
    • Journal of Gastric Cancer
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    • v.8 no.4
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    • pp.176-181
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    • 2008
  • Purpose: The adipocyte-derived cytokine leptin plays a major role in the control of stable body weight by suppressing food intake and increasing energy metabolism. Leptin regulates the cell proliferation of various epithelial cells and it may be involved in the promotion of cancer. Leptin and its receptor are highly expressed in gastric adenocarcinoma, but the association between the serum leptin level and the tissue expression of leptin is uncertain. We evaluated the serum leptin level and the expressions of leptin and leptin receptor in gastric cancer, and we explore the possible mechanism and role of leptin in the carcinogenesis of gastric cancer. Materials and Methods: 72 carcinomas that were curatively resected at our hospital from October 2005 to March 2007 were included in this study. By immunoassay and immunohistochemical staining, we evaluated the serum leptin level and the expressions of leptin and its receptor, and we analyzed their relationship together with the clinicopathological variables. Results: The serum leptin level was increased as the patient's BMI increased and it was decreased in H. pylori infected patients. The expression of leptin was increased as the TNM stage increased (P=0.014), and the expression of leptin receptor in the intestinal type gastric adenocarcinoma was higher than that in the diffuse type gastric adenocarcinoma (71.4% vs 28.6%, respectively, P=0.033). Conclusion: There was no significant correlation between the serum leptin level and expression of leptin in gastric cancer patients. The expression of leptin was associated with the TNM stage, but its role in the pathogenesis of gastric cancer has to be elucidated.

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Comparison of Liver, Kidney, Bone Metal Concentration in OhJeokSan-Treated Rats (오적산(五積散)을 투여한 흰쥐의 간장, 신장, 골중 금속농도 비교에 관한 연구)

  • Park Chul-Soo;Lee Sun-Dong;Park Hae-Mo;Park Yeong-Chul
    • Journal of Society of Preventive Korean Medicine
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    • v.6 no.2
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    • pp.66-85
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    • 2002
  • Traditional herbal medicine is used extensively among the Korean populations, and other Asian countries employ similar therapies as well In recent years, extensive focus was laid on adulteration of the herbal medicine with heavy metals. This may be mainly due to a soil contamination by an environmental pollution. The objective of this study is to identify the contents of various heavy metals in the blood from OhJeokSan-Decoction (OD) treated-rats. For this study, 13 kinds of metals including essential and heavy metals, i.e. Al, As, Cd, Co, Cr, Cu, Fe, Hg, Mn, Ni, Pb, Se and Zn were analyzed by a slight modification of EPA methods and the following results are obtained. ; 1. There is no significant difference between the OD-treated groups and control group in liver, kidney, bone, brain, weight, food intake. 2. The amount of each metal analyzed in the liver are as follows; Al ; $0.235{\sim}4.215mg/kg$, As ; $0.103{\sim}0.461mg/kg$, Cd ; $0.005{\sim}0.010mg/kg$, Co ; $0.017{\sim}0.046mg/kg$, Cr ; $0.137{\sim}0.403mg/kg$, Cu ; $1.736{\sim}4.827mg/kg$, Fe ; $54.472{\sim}381.447mg/kg$, Hg ; not detected, Mn ; $1.159{\sim}2.803mg/kg$, Ni ; $0.007{\sim}0.095mg/kg$, Pb ; not detected, Se ; $0.682{\sim}1.887mg/kg$, Zn ; $10.213{\sim}26.119mg/kg$, by groups, respectively. In control and other experimental group, several metal (Co, Cu, Mn, Zn, As, Cr) has a significant difference, but in experimental I and other experimental II, III, IV, V groups, there are no significant difference. 3. The amount of each metal analyzed in the kidney are as follows; Al ; $1.712{\sim}31.230mg/kg$, As ; $0.062{\sim}0.439mg/kg$, Cd ; $0.010{\sim}0.062mg/kg$, Co ; $0.000{\sim}0.101mg/kg$, Cr ; $0.125{\sim}0.636mg/kg$, Cu ; $3.385{\sim}12.502mg/kg$, Fe ; $41.148{\sim}99.709mg/kg$, Hg ; $0.000{\sim}0.270mg/kg$, Mn ; $0.433{\sim}2.301mg/kg$, Ni ; $0.000{\sim}0.221mg/kg$, Pb ; $0.000{\sim}0.584mg/kg$, Se ; $0.540{\sim}1.600mg/kg$, Zn ; $8.775{\sim}17.060mg/kg$, by groups, respectively. The concentration of Cu, Se, Cr, and Hg are variated significantly in control and other experimental group, and Cu, Se, Cd, Cr are variated significantly in experimental I and other experimental II, III, IV, V groups. 4. The amount of each metal analyzed in the bone(tibia and fibula) are as follows; Al ; $9.557{\sim}119.464mg/kg$, As ; $0.139{\sim}12.250mg/kg$, Cd ; $0.000{\sim}0.295mg/kg$, Co ; $0.022{\sim}0.243mg/kg$, Cr ; $0.239{\sim}1.999mg/kg$, Cu ; $0.000{\sim}2.291mg/kg$, Fe ; $240.249{\sim}841.956mg/kg$, Hg ; $0.000{\sim}0.983mg/kg$, Mn ; $0.214{\sim}7.353mg/kg$, Ni ; $5.473{\sim}11.453mg/kg$, Pb ; $0.000{\sim}8.502mg/kg$, Se ; $0.000{\sim}3.005mg/kg$, Zn ; $61.158{\sim}195.038mg/kg$, by groups, respectively. The concentration of Se, Cd are variated significantly in control and other experimental groups, and Se is variated significantly in experimental I and other experimental II, III, IV, V groups. 5. Exceptionally several metal concentration is increased or decreased. but there is no significant harmful difference of metal concentration in the liver, kidney and bone, from the OD-treated-rats compared to those of the control group even if higher dosage($1{\sim}8$ times dosage of person) of OD was administered. Thus, it is expected that the herbal decoction in the traditional herbal medicine would not lay any burden on the body and the heavy metal toxins would not affect our physiological system. However, other kinds of herbal treatment, such as i.v. and i.p. should be considered in terms of metal toxicity in the body since the level of certain metal.

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The Prevalence and Associated Factors of Constipation in the School-aged Children (학동기 아동에서 변비의 실태와 관련요인에 대한 연구)

  • Cho, Sung-Jong;Ahn, Young-Jun;Kim, Eun-Young;Rho, Young-Ill;Yang, Eun-Suk;Park, Young-Bong;Moon, Kyung-Rye
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.5 no.1
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    • pp.26-32
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    • 2002
  • Purpose: Constipation in childhood is a significant problem, however, understanding of its epidemiology has been limited in Korea. The aim of this study was to investigate the prevalence and risk factors of constipation in school-aged children, helping to manage and prevent it. Methods: This cross-sectional, descripsive observational prevalence study included children (2grade, 1st and 6th grade) who were attending two elementary schools in Gwangju. The prevalence of constipation, associated symptoms, and risk factors were evaluated by questionnaire. A child was considered to be constipated when he or she defecated two or less times per week. Results: The prevalence of constipation was 15.4%. There is no significant difference between both sexes and grades. Of the causes of constipation, there was statistically significant difference in exercise deficiency, frequent intake of convenience food, long-time watching TV, unbalanced diet and enuresis history between constipation and normal group. Especially, long-time watching TV, exercise deficiency, and enuresis history were risk factors for development of constipation. Only 27.1% of children with constipation were treated by laxative and enema. Conclusion: Even though the prevalence of constipation was high, more than half of them was not treated at all. We should endeavor to educate the children and their parents to prevent constipation by evaluating the feeding and behavioral habit completely, and treating them properly.

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Study on health anxiety issues, health-promoting behavior, and quality of life of middle-aged women in Jeonbuk area (전북지역 중년여성의 건강염려, 건강증진행동 및 삶의 질에 대한 연구)

  • Jeon, Sun Young;Chung, Sung Suk;Rho, Jeong Ok
    • Journal of Nutrition and Health
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    • v.53 no.6
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    • pp.613-628
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    • 2020
  • Purpose: The purpose of the study was to identify the health anxiety issues of middle-aged women, their health-promoting behavior, and quality of life as well as to examine the relationship between these variables. Methods: The participants were 334 women in Jeonbuk area. Demographic characteristics, the status of health anxiety, health-promoting behavior, and life quality was assessed using a self-administered questionnaire. The data were analyzed using a t-test, analysis of variance, Duncan test, and hierarchical regression analysis with SPSS ver. 24.0. Results: The score for health anxiety was 37.64 points out of a possible score of 60, and the score for health-promoting behavior was 79.18 points out of a possible score of 115. The score for the quality of life was 101.18 points out of a possible score of 150. The health anxiety scores showed significant differences, varying as per body mass index (BMI) (p < 0.05), income (p < 0.05), occupation (p < 0.05), disease (p < 0.05), satisfaction with weight (p < 0.05), and interest in weight control (p < 0.05). The health-promoting behavior showed significant differences according to age (p < 0.01), BMI (p < 0.01), income (p < 0.05), menses (p < 0.05), intake of dietary supplements (p < 0.05), perception of body image (p < 0.05), and satisfaction with weight (p < 0.05). The quality of life showed significant differences according to BMI (p < 0.05), income (p < 0.01), education level (p < 0.05), occupation (p < 0.05), disease (p < 0.05), and satisfaction with weight (p < 0.05). Regression analysis showed that health-promoting behavior was the most influential variable on the quality of life, followed by disease and health anxiety. Conclusion: Based on these results, we conclude that it is necessary to consider educational programs on improving the quality of life of middle-aged women according to the health anxiety levels and health-promoting behavior.

A review of the mass-mortalities of sea-cage farm fishes (해상 가두리양식장 양식어류의 대량폐사에 대하여)

  • Han, Jido;Lee, Deok-Chan
    • Journal of fish pathology
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    • v.35 no.1
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    • pp.1-25
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    • 2022
  • The aquaculture industry has developed rapidly over the last three decades and is an important industry that supplies over 15% of humans' animal protein intake; therefore, there is a need to increase production to meet the continuous demand. The fish cage farms on the southern coast (Kyengsangnam-do and Jeollanam-do) of Korea are critical resources in aquaculture because they account for approximately 90% of the national total fish cage farms by water area ratio. However, the current aquaculture environment is being gradually affected by climate change, which is a global issue, and its effects are expected to intensify in the future. Therefore, it is urgently imperative to accurately evaluate the effects of climate change on South Korean aquaculture industries and to develop social and national strategies to minimize damage to the fishing industry. The damage to fish farmed in cage farms on the southern coast is increasing annually and the leading causes are high and low water temperature and red tides, which are directly or indirectly related to climate change. At present, global warming can provide opportunities for aquaculture industrialization of fish or other novel species, with economic implications. However, despite such opportunities, the influx of new species can also cause problems such as ecological disturbances, increase in the reproduction frequency of microalgae such as red tide, increase in disease incidence, and occurrence and periods of high water temperatures in summer. The scale of farmed fish mortality is increasing due to the complex effects of these factors. Increased damages due to fish mortality not only have severe economic impacts on the aquaculture industry, but the social costs of responding to the damage and follow-up measures also increase. various active responses can reduce the mortality damage in fish farms such as improving the management skills in aquaculture, improved species breeding, efficient food management, disease prevention, proactive responses, and system-wide improvements. This review article analyzes the large-scale mortality cases occurring in fish cage farms on the southern coast of Korea and proposes measures to mitigate mortality and enhance responses to such scenarios.

Study on individual characterization of sweat components (개체별 땀의 성분분포에 관한 연구)

  • Choi, Mi Jung;Ha, Jaeho;Yoo, Seok;Park, Sung Woo
    • Analytical Science and Technology
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    • v.20 no.5
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    • pp.434-441
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    • 2007
  • The aim of this paper is to investigate composition of fatty acids in sweat on purpose of latent fingerprint detectant developing and crime evidence searching. Fingerprint from 5 male donors (aged 29-50 years) were collected. We identified fatty acid components on sweat using methylester mixture (37species) as standard fatty acid and analyzed them by GC-FID. As donor was aged, the level of total fat was found to decrease markedly (aged 20-30 years: 56.4-72.0 %, aged 50 years : 32.4-45.4 %). We identifided 28 species fatty acid, primarilly C16:0(palmitic acid), C16:1 (palmitoleic acid), C18:1n9c(oleic acid), C18:0 (stearic acid), C14:0 (tetradecanoic acid) and all sweats were found to contain C12:0 (lauric acid), C15:0 (pentadecanoic acid), C18:2n6c (linoleic acid), C18:2n6t (linolelaidic acid), C20:0 (arachidic acid), C24:0/C20:5n3 (lignoceric acid/eicosapentaenoic acid), but with differing frequencies and at varying levels. C14:1 (myristoleic acid), C15:1 (pentadecenoic acid), C21:0 (heneicosanoic acid), C22:1n9 (erucic acid) were often observed in sample. Ratio of saturated and unsaturated fatty acid was from 0.94:1 to 2.6:1. And decrease of total fatty acids components caused by loss of saturated fatty acid and monounsaturated fatty acid. In case of sweat amino acids, we detected serine ($0-31.9{\mu}L/mL$), threonine ($0-26.2{\mu}L/mL$), glycine ($0-18.9{\mu}L/mL$) and 20-30 years old, highly protein intake ratio individuals increased (10 times) than 50 years old. We observed greatly individual characterization of amino acid compounds in sweat.

Studies of nutrient composition of transitional human milk and estimated intake of nutrients by breast-fed infants in Korean mothers (한국인 수유부의 수유초기 이행유의 모유성분 분석과 영아의 섭취량 추정 연구)

  • Choi, Yun Kyung;Kim, Nayoung;Kim, Ji-Myung;Cho, Mi Sook;Kang, Bong Soo;Kim, Yuri
    • Journal of Nutrition and Health
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    • v.48 no.6
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    • pp.476-487
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    • 2015
  • Purpose: This study was conducted to examine the concentration of nutrients in transitional breast milk from Korean lactating mothers and to evaluate daily intakes of their infants based on the Dietary Reference Intakes for Koreans 2010 (KDRIs 2010). Methods: Breast milk samples were collected at 5~15 days postpartum from 100 healthy lactating Korean mothers. Macro- and micro-nutrients, and immunoglobulin (Igs) concentrations in breast milk were analyzed. Results: The mean energy, protein, fat, and carbohydrate concentrations in breast milk were $59.99{\pm}8.01kcal/dL$, $1.47{\pm}0.27g/dL$, $2.88{\pm}0.89g/dL$, and $6.72{\pm}0.22g/dL$. The mean linoleic acid (LA), a-linolenic acid (ALA), arachidonic acid (AA), and docosahexaenoic acid (DHA) concentrations were $181.44{\pm}96.41mg/dL$, $28.15{\pm}8.89mg/dL$, $5.67{\pm}1.86mg/dL$, and $5.74{\pm}2.57mg/dL$. The mean vitamin A, vitamin D, vitamin E, vitamin $B_1$, vitamin $B_2$, vitamin $B_{12}$, and folate concentrations were $2.75{\pm}1.75{\mu}g/dL$, $2.31{\pm}1.12ng/dL$, $0.74{\pm}1.54mg/dL$, $3.02{\pm}1.84mg/dL$, $7.51{\pm}20.96{\mu}g/dL$, $61.78{\pm}26.78{\mu}g/dL$, $63.71{\pm}27.19ng/dL$, and $0.52{\pm}0.26{\mu}g/dL$. The mean concentrations of calcium, iron, potassium, sodium, zinc, and copper were $20.71{\pm}3.34mg/dL$, $0.59{\pm}0.86mg/dL$, $66.71{\pm}10.35mg/dL$, $27.72{\pm}10.16mg/dL$, $0.44{\pm}0.41mg/dL$, and $70.48{\pm}30.41{\mu}g/dL$. The mean IgA and total IgE concentrations were $61.85{\pm}31.97mg/dL$ and $235.00{\pm}93.00IU/dL$. The estimated daily intakes of infants for protein, vitamin D, vitamin E, vitamin $B_2$, vitamin $B_{12}$, iron, potassium, sodium, zinc, and copper were sufficient compared to KDRIs 2010 adjusted by transitory milk intakes. The estimated infants' intakes of energy, fat, carbohydrate, vitamin A, vitamin C, vitamin $B_1$, folate, and calcium did not meet KDRIs 2010 adjusted by transitory milk intakes. Conclusion: In general most estimated nutrient intakes of Korean breast-fed infants in transitory breast milk were sufficient, however some nutrient intakes were not sufficient based on KDRIs 2010. These results warrant conduct of future studies for investigation of important dietary factors associated with nutrients in breast milk to improve the quality of breast milk, which may contribute to understanding nutrition in early life and promoting growth and development of breast-fed infants.

Vitamin $B_{12}$ Contents in Some Korean Fermented Foods and Edible Seaweeds (한국의 장류, 김치 및 식용 해조류를 중심으로 하는 일부 상용 식품의 비타민 $B_{12}$ 함량 분석 연구)

  • Kwak, Chung-Shil;Hwang, Jin-Yong;Watanabe, Fumio;Park, Sang-Chul
    • Journal of Nutrition and Health
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    • v.41 no.5
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    • pp.439-447
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    • 2008
  • There is a limitation to estimate vitamin $B_{12}$ intake due to lack of data on vitamin $B_{12}$ content in many Korean foods. In this study, vitamin $B_{12}$ content was determined in some soybean or vegetable-fermented foods, edible seaweeds and other frequently consumed foods in Korea by microbioassay using Lactobacillus delbruecki ATCC 7830. The traditional type of Doenjang and Chungkookjang contained 1.85 ${\mu}g/100$ g and 0.69 ${\mu}g/100$ g of vitamin $B_{12}$, respectively, while the factory-type of Doenjang and Chungkookjang contained 0.04-0.86 ${\mu}g/100$ g and 0.06-0.15 ${\mu}g/100$ g. Vitamin $B_{12}$ was not detected in steamed soybeans and Tofu which is a not-fermented soybean product, indicating that vitamin $B_{12}$ in Doenjang and Chungkookjang might be produced during the fermentation process. The Korean-style soy sauce contained 0.04 ${\mu}g$ vitamin $B_{12}$/100 mL, but vitamin $B_{12}$ was not detected in Japanese-style soy sauce and white miso. Commercial Kimchi, a representative Korean vegetable- fermented food, made of Korean cabbage, Yeolmu, or Mustard leaves contained 0.013-0.03 ${\mu}g$ vitamin $B_{12}$/100 g, while Kimchi without red pepper and fermented fish sauce (White Kimchi) did not. Vitamin $B_{12}$ content was very high in some edible seaweeds such as laver (66.76 ${\mu}g/100$ g dry weight) and sea lettuce (84.74 ${\mu}g/100$ g dry weight), and it was 17.12 ${\mu}g/100$ g of dried small anchovy, 1.07 ${\mu}g/100$ g of whole egg, and 0.02 ${\mu}g/100$ g of coffee mix. From these results, it is assumed that Koreans take substantial amount of vitamin $B_{12}$ from plant-origin foods. And, with these data, we will be able to calculate dietary vitamin $B_{12}$ content more correctly than before. In conclusion, soybean-fermented foods, Kimchi, laver and sea lettuce are recommendable as good sources of vitamin $B_{12}$ for vegetarians or Korean elderly on grain and vegetable based diet.

Nutritional Studies for Improvement of Feeding on Korean Native Goat - Absorption of Nutrients in Rumen - (한국재래산양(韓國在來山羊)의 사양개선(飼養改善)에 관(關)한 연구(硏究) - 제일위((第一胃)에서의 영양소(營養素) 흡수(吸收)에 대(對)하여 -)

  • Kwon, Soon Ki
    • Korean Journal of Agricultural Science
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    • v.9 no.1
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    • pp.284-302
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    • 1982
  • Development of protein resources as food has been a big issue especially in Southeast Asia region, and intake of protein is also insufficient in Korea. To cope with this shortage of protein resources and its improvement together with increased production of high nutritive animal protein, studies were carried out on feeding of Korean native goats. In the experiments were made absorption of carbohydrate and volatile fatty acid in miniature rumen, and absorption of amino acid in rumen as in vivo were conducted as part of studies on nutritional absorption in rumen. Those nutritional for improvement of feeding and management as described above are summarized as following. 1. According to the result of test on the nutritional absorption of native goat by means of miniature rumen method, absorption ratio of VFA measured at 0.5, 1 and 2 hours after injection of nutrition showed propionic acid 70-86%, acetic acid 74-87%, and lactic acid 76-89%. In the absorption of organic substances, ethyl alcohol of 0.5% showed 29-87% and lactic acid of 0.1M showed 12-27% of absorption ratio. 2. Result of absorption measurement in rumen from L-type free amino acid injection in the content of rumen vein showed lower rate at menthionine-free group compared to whole-egg amino acid injection in the content of rumen vein showed lower rate at methioine-free group compared to whole-egg amino acid group, and high absorption ratio was observed at methionine 3 times group and urea added group. Deficiency of methionine caused no change of the content in mucous membranes. 3. Absorption of amino acid in rumen muscular layer showed equal tendency as in the mucous membrane without exerting any influence of methionine deficiency. At the methionine3-times group, content of methionine and glutamine were increased by 14.7 and 4.4 times as compared to whole-egg amino acid group, an absorption ratio of glutamine, proline and valine were increased at urea added group. 4. In general, concentration of amino acid in rumen vein plasma was lower than in rumen mucous membrane and muscular layer. Absorption ratio of amino acid is decreased due to methionine deficiency, and tripling of methionine or urea adding caused increment of amino acid. Absorption pattern is thus varied depending on the composition of amino acid. 5. At the urea added group, content of ammonia-N, amino-N and urea were increased in rumen muscular layer. As the inside of goat's rumen was unable to clean thoroughly, investigation was made on remaining bacteria, however, variation of ammonia-N was affected by these bacterial content. 6. Variation in rumen structure by differential absorption of amino acid was observed by general microscope and fluorescent microscope. According to the result of observation in the methionine 3 times group, single cylinder epithelium of mucous membrane showed rather thin, and it was thick at urea added group though no significant differences existed among test groups in submucous membrane and muscular layer.

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The Early Experience with a Totally Laparoscopic Distal Gastrectomy (전(全)복강경하 원위부 위절제술의 초기 경험)

  • Kim Jin Jo;Song Gyo Young;Chin Hyung Min;Kim Wook;Jeon Hae Myoung;Park Cho Hyun;Park Seung Man;Lim Keun Woo;Park Woo Bae;Kim Seung Nam
    • Journal of Gastric Cancer
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    • v.5 no.1
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    • pp.16-22
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    • 2005
  • Purpose: In Korea, the number of laparoscopy-assisted distal gastrectomies for early gastric cancer patients has been increasing lately. Although minimally invasive surgery is more beneficial, no reported case of a totally laparoscopic distal gastrectomy has been reported because of difficulty with intracorporeal anastomosis. This study attempts, through our experiences, to determine the feasibility of a totally laparoscopic distal gastrectomy using an intracorporeal gastroduodenostomy in treating early gastric carcinoma. Materials and Methods: We investigated surgical results and clinicopatholgic characteristics of eight(8) patients with an early gastric carcinoma who underwent a totally laparoscopic distal gastrectomy at the Department of Surgery, Our Lady of Mercy Hospital, The Catholic University of Korea, between June 2004 and September 2004. The intracorporeal gastroduodenostomy was performed with a delta-shaped ananstomosis by using only laparoscopic linear staplers (Endocutter 45mm; Ethicon Endosurgery, OH, USA). Results: The operative time was $369.4\pm62.5$ minutes (range $275\∼465$ minutes), and the anastomotic time was 45.1\pm14.4$ minutes (range $32\∼70$ minutes). The anastomotic time was shortened as surgical experience was gained. The number of laparoscopic linear staplers for an operation was $7.1\pm0.6$. The number of lymph nodes harvested was $31.9\pm13.1$. There was 1 case of transfusion and no case of conversion to an open procedure. The time to the first flatus was 2.8$\pm$0.5 days, and the time to the first food intake was $4.1\pm0.8$ days. There were no early postoperative complications, and the postoperative hospital stay was $10.0\pm3.9$ days. Conclusion: A totally laparoscopic distal gastrectomy using an intracorporeal gastroduodenostomy with a delta-shaped anastomosis is technically feasible and can maximize the benefit of laparoscopic surgery for early gastric cancer.

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