Koh, Won-Jung;Kwon, O Jung;Yu, Chang-Min;Jeon, Kyeongman;Kim, Kyung Chan;Lee, Byoung-Hoon;Hwang, Jung Hye;Kang, Eun Hae;Suh, Gee Young;Chung, Man Pyo;Kim, Hojoong
Tuberculosis and Respiratory Diseases
/
v.56
no.3
/
pp.248-260
/
2004
Background : As an effective regimen for isoniazid (INH)-resistant pulmonary tuberculosis, several treatment regimens have been recommended by many experts. In Korea, a standard regimen has not been established for INH-resistant tuberculosis, and the treatment by individual physicians has been performed on an empirical bases. The purpose of the present study was to retrospectively describe the treatment characteristics and evaluate the treatment outcomes of patients with INH-resistant tuberculosis. Materials and Methods : Sixty of 69 patients reported to have INH-resistant tuberculosis from 1994 to 2001 were retrospectively analyzed. Exclusion criteria included: death from other causes, with the exceptions of tuberculosis and incomplete treatment, including a patient's transfer-out. Results : A previous tuberculosis history was found in 28 (46.7%) patients. The sputum smear for acid-fast bacilli was positive in 44 (73.3%) patients, and 30 (50.0%) had cavitary disease. Streptomycin resistance coexisted in 25.0% of isolates. INH was to be prescribed continuously, even after INH resistance was reported, in 86.0% of patients. The treatment regimens were diverse between the patients according to drug regimen composition and treatment duration. The most frequent prescribed regimen included rifampin, ethambutol and pyrazinamide, with and without INH, for the full 12-month term of treatment. Treatment failure occurred in 13 (21.7%) patients. Cavitary disease (p=0.005) and a treatment regimen with second-line drugs, excluding rifampin (p=0.015), were associated with treatment failure. One patient experienced a relapse. Conclusions : Standardized treatment guidelines will be needed in Korea to improve the treatment efficacy for INH-resistant tuberculosis.
Purpose: The postoperative hospital stay after gastric cancer surgery is usually 8 to 14 days. The main reason for a prolonged hospital stay may be the 3 to 4 day period of postoperative starvation. The aim of this study is to investigate the feasibility of a critical pathway for early recovery after gastric cancer surgery, and this pathway included early postoperative feeding. Materials and Methods: One hundred three consecutive patients who underwent gastric resection and reconstruction for gastric cancer from October 2007 to June 2008 at St. Mary's Hospital were prospectively enrolled in a fast-track critical pathway. The pathway included minimal preoperative procedures, optimal pain relief, proper fluid administration, early mobilization and early enteral nutrition at postoperative 1 day. The exclusion criteria were determined preoperatively, intraoperatively and postoperatively. Results: Of the 103 patients, 19 patients were excluded for preoperative (5), intraoperative (7) and postoperative (7) reasons. Eighty-four patients (81.6%) were included in the fast-track critical pathway. Sixty-eight (88.6%) of 84 patients were discharged at the planned 8 day after surgery during the initial period of the study, and the postoperative hospital stay was shortened up to 6 days during the more recent period. Postoperative complications occurred in 22 patients (26.2%), and these were gastrointestinal track-related complications in 6 cases (3 cases of ileus, 1 case of stasis and 2 cases of leakage) and infection-related complications in 8 cases. There was no statistical difference in the incidence of morbidity according to the clinic-operative features that included age, gender, stomach resection and lymphadenectomy. Conclusion: The fast-track critical pathway with using the available exclusion criteria was a valid option for patients who underwent gastric cancer surgery.
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.
Purpose: An uncut Roux-en-Y gastrojejunostomy has been known to be effective in preventing bile reflux gastritis in the remnant stomach and the Roux stasis syndrome. Materials and Methods: To evaluate the usefulness of a totally laparoscopic uncut Roux-en-Y gastrojejunostomy (TLuRYGJ) after a distal gastrectomy, we reviewed the medical records of 19 consecutive patients that underwent a TLuRYGJ at our institution, and 11 consecutive patients who underwent a totally laparoscopic Billroth I gastrectomy (TLB-I) during the same period. Results: Postoperative gastrointestinal symptoms related to the postgastrectomy syndrome and the Visick classification at six months after surgery were not different in the two groups; however, there was no case of symptomatic bile reflux gastritis and only one case of delayed gastric empting, for which medication was required, in the TLuRYGJ group. The endoscopic findings of the remnant stomach for bile reflux gastritis at six months after surgery were better in the TLuRYGJ group than in the TLB-I group. Conclusion: A TLuRYGJ was found to be effective in preventing bile reflux gastritis and the Roux stasis syndrome.
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.
Purpose: Pledget is a PTFE felt that is usually used for suture reinforcement in cardiovascular surgery. In order to minimize the difficulty in intracorporeal continuous gastrointestinal suturing by reducing the number of tied knots, we have used pledget as substitute for a knot (pledget suturing). Materials and Methods: Thirty-two consecutive patients who underwent totally laparoscopic uncut Roux-en-Y gastrojejunostomy after distal gastrectomy in our institution were enrolled in this study, and the patients were divided into three groups according to the method of intracorporeal anastomosis. Basically, intracorporeal anastomosis was performed by several firings of linear staplers; however, the entry holes for the stapler at the jejunojejunostomy and the gastrojejunostomy were closed by pledget suturing in group A (8 patients), the entry hole for the stapler at jejunojejunostomy was closed by conventional suturing in group B (8 patients), and all of the entry holes for the stapler were closed by stapling in group C (16 patients). The surgical outcomes of each group were compared to each other. Results: The anastomotic time in group A was not longer than in group B, although there were more sutures used in group A, but it was longer than in group C. The number of stapler cartridges used in group A was the smallest among the three groups. In group B, there were two cases of a break of suture material during anastomosis, there were no such cases in group A. There was no complication related to anastomosis in all of the groups. Conclusion: Pledget was found to be useful for minimizing the difficulty in intracoproreal continuous gastrointestinal suturing and reducing the number of stapler cartilages used in intracorporeal anastomosis.
This study was carried out to investigate the effect of irrigation method adopted for reducing nutrient solution drainage on the root zone environment, growth and yield of a tomato crop grown in a rockwool medium. The irrigation control methods used were large quantity irrigation at a long interval controlled by only an integrated solar radiation sensor (standard), medium quantity irrigation at a medium interval (zero drainage 1), and small quantity irrigation at a short interval (zero drainage 2) controlled by both an integrated solar radiation sensor and a zero drainage sensor. The amount of the nutrient solution supplied and the drain percentage per plant of the standard, zero drainage 1, and zero drainage 2 were 1.4, 0.9 and 0.8 L, and 23.8, 8.6 and 3.7%, respectively. The average, minimum, and maximum water contents and EC of the standard, zero drainage 1, and zero drainage 2 were 64.5~88% and $1.5{\sim}3.5dS{\cdot}m^{-2}$, 40.3~76.0% and $2.5{\sim}4.0dS{\cdot}m^{-2}$, and 56.3~69.0% and $2.7{\sim}3.7dS{\cdot}m^{-2}$, respectively. There was no difference in leaf width, number of leaves, and stem diameter among the treatments. However, plant height and leaf length decreased in the zero drainage 1 and 2 treatments as compared to the standard. The fruit marketable yield per 10a in the zero drainage 1 and 2 treatments was about 93 and 88%, respectively, of that in the standard treatment.
Choi, Jae Chol;Koh, Won-Jung;Kwon, Yong Soo;Ryu, Yon Ju;Yu, Chang-Min;Jeon, Kyeongman;Kang, Eun Hae;Suh, Gee Young;Chung, Man Pyo;Kim, Hojoong;Kwon, O Jung;Kim, Tae Sung;Lee, Kyung Soo;Han, Joungho
Tuberculosis and Respiratory Diseases
/
v.58
no.6
/
pp.576-581
/
2005
Background : Thoracic actinomycosis is a relatively uncommon anaerobic infection caused by Actinomyces israelii. There have been only a few case reports of endobronchial actinomycosis. The aim of this study was to evaluate the clinical manifestation and treatment of endobronchial actinomycosis. Material and Methods : Seven patients with endobronchial actinomycosis, who were diagnosed in the past 10 years, were retrospectively reviewed. Results : Cough and sputum were the most common symptoms. The chest radiograph and computed tomography showed necrotic consolidation (n=3), atelectasis (n=2), mass (n=1) and an endobronchial nodule (n=1). Proximal broncholithiasis was observed in five patients. All cases were initially suspected to have either lung cancer or tuberculosis. In these patients, the median duration of intravenous antibiotics was 3 days (range 0-12 days) and the median duration of oral antibiotics was 147 days (range 20-412 days). Two patients received oral antibiotic therapy only. There was no clinical evidence of a recurrence. Conclusion : Endobronchial actinomycosis frequently manifests as a proximal obstructive calcified endobronchial nodule that is associated with distal post-obstructive pneumonia. The possibility of endobronchial actinomycosis is suggested when findings of broncholithiasis are present at chest CT. The traditional recommendation of 2-6 weeks of intravenous antibiotics and 6-12 months of oral antibiotic therapy are not necessarily essential in all cases of endobronchial actinomycosis.
'Seolgaeng' is a new Japonica rice variety developed from an 'Ilpumbyeo' mutant line, N-methyl-N-nitrosourea (MNU) treatment on fertilized egg cell, by a rice breeding team of National Crop Experiment Station, Rural Development Administration in 2001. This variety has about 134 days of growth duration from transplanting to harvesting in central plain area of Korea, a good semi-elect plant type and resistant to lodging with strong culm. The number of panicles/hill of 'Seolgaeng' is more than that of 'Hwaseongbyeo'. The milled rice appearance of this cultivar is an opaque, but it has amylose content (19.3%) similar to 'Hwaseongbyeo'. It is superior to hypae formation of Aspergillus orzyae in the making of fermented rice and amount of pigmentation in fermented rice by Monascus anka that of 'Ilpumbyeo'. This variety showed slow leaf senescence and considerable resistance to viviparous germination. It is moderately resistant to leaf blast and susceptible to bacterial blight, virus disease and insect pests. The yield performance of this rice cultivar is about 5.27 MT/ha in milled rice in local adaptability test for three years from 1999 to 2001). 'Seolgaeng' is adaptable to central and southern plain areas of Korea.
Pintail (Anas acuta) is the major wintering bird in South Korea and known as a major mediator of the highly pathogenic avian influenza (HPAI). Pintail migrates long distances between Russian Siberia and Korea. This species prefers a rice paddy area as their winter habitat. The purpose of this study is to provide the data necessary for the conservation and management of bird habitats in Korea by understanding the wintering home-range and habitat of pintail in Korea. We captured six pintails using a cannon-net in the winter of 2015 and attached the GPS-mobile phone based telemetry (WT-300) on them to study the wintering home-range and wintering habitat. We analyzed the tracking location data using ArcGIS 9.0 Animal Movement Extension and calculated Kernel Density Estimation (KDE) and Minimum Convex Polygon (MCP). The average home-range in the wintering ground analyzed by MCP was $677.3km^2$ (SD=130.2, n=6) while the maximum and minimum were $847.7km^2$ and $467.5km^2$, respectively. Extents of home-range analyzed by KDE were $194.7km^2$ (KDE 90%), $77.4km^2$ (KDE 70%), and $35.3km^2$ (KDE 50%). The pintails mostly used both sea and paddy field as habitat in the winter season and utilized paddy fields more during the nighttime and than the daytime. We concluded that the home-range and habitat of pintails in the winter could be used as the reference data for the preservation of species, management of habitats, and coping with a breakout of HPAI.
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