• Journal of Gastric Cancer
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• v.8 no.4
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• pp.225-231
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• 2008

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

• Journal of Gastric Cancer
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• v.8 no.4
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• pp.232-236
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• 2008

Purpose: Laparoscopic surgery for gastric cancer was introduced in the past decade because it was considered less invasive than open surgery, and this results in less postoperative pain, faster recovery and an improved quality of life. Several studies have demonstrated the safety and feasibility of this procedure. We examined the outcome of performing laparoscopic surgery for gastric cancer over the last two year. Materials and Methods: From April 2004 to December 2006, 329 patients with gastric adenocarcinoma underwent a laparoscopy-assisted distal gastrectomy with lymph node dissection. The data was retrospectively reviewed in terms of the clinicopathologic findings, the perioperative outcomes and the complications. Results: The total patient group was comprised 196 men (59.6%) and 133 women (40.4%). The mean BMI was 23.6 and the mean tumor size was 2.7 cm. The mean number of harvested lymph node was 22.7, and this was 18.6 before 30 cases and 23.1 after 30 cases, and the difference was significant (P=0.02). The mean operation time was 180.9 min, and this was than 287.9 min before 30 cases and 170.2 min after 30 cases. After 30 cases, there was a significant improvement of the operation time (P<0.01). The mean incision length after 30 cases was shorter than that before 30 cases (P<0.01). Postoperative complications occurred in 24 (7.3%) of 329 patients and there was no conversion to open surgery. Conclusion: Even though the LADG was accompanied by a difficult learning curve, we successfully performed 329 LADG procedures over the past 2 years and we believe that LADG is a safe, feasible operation for treating most early gastric cancers (EGC).

• Journal of Gastric Cancer
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• v.8 no.4
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• pp.256-261
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• 2008

Purpose: Intra-abdominal fluid collection is one of the risk factors associated with postoperative morbidity or mortality for patients who undergo gastric cancer surgery. The aim of this study was to analyze the clinicopathological characteristics of the patients with postoperative intra-abdominal fluid collection and to identify the indications for inserting a percutaneous drain (PCD) in patients with intra-abdominal fluid collection. Materials and Methods: Among the 1,277 patients who underwent operations for gastric cancer at Seoul National University Hospital between April 2005 and July 2006, the data of 117 patients with an intra-abdominal fluid collection were reviewed. Results: The number of patients' with pathologic stage I, II, III and IV disease was 42 (36.8%), 23 (20.2%), 16 (14%) and 33 (28.9%), respectively. Forty-three patients (36.3%) underwent PCD insertion and the other 43 patients received conservative management. A univariate analysis of multiple clinical variables revealed that age, gender, diabetes, liver disease, lymph node dissection, the pathologic stage and the body mass index (BMI, $kg/m^2$) were not significantly associated with PCD insertion (P>0.05). However, the univariate analysis showed that two characteristics were associated with a significantly high incidence of PCD insertion: a diameter of an intra-abdominal fluid collection greater than 4 cm and infectious signs such as leukocytosis, fever and bacteremia. Conclusion: About two thirds of the intra-abdominal fluid collections after surgery for gastric cancer were managed with only conservative method without other morbidities of mortality. Surgeons should consider performing PCD insertion if the largest diameter of an intra-abdominal fluid collection is over 4 cm or if infectious signs are seen.

• Journal of Gastric Cancer
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• v.8 no.4
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• pp.169-175
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• 2008

Purpose: The main target of 5-fluorouracil (5-FU) is thymidylate synthase (TS). A high TS expression has been identified as promoting resistance to 5-FU. For colorectal cancers, the response to 5-FU based adjuvant chemotherapy is different according to the microsatellite instability (MSI) status. The reports on the relationship between MSI and the TS expression in colorectal cancer have been inconsistent. No data is available for gastric cancer regarding the relationship between MSI and the TS expression. Therefore, we studied the relationship between MSI and the TS expression in gastric cancer. Materials and Methods: Ninety-nine consecutive patients who underwent radical gastrectomy for gastric cancer from January 2004 to May 2006 at Bundang CHA hospital were studied. MSI was assessed for five markers (BAT25, BAT26, D2S123, D5S346, and D17S250) by PCR and with using an ABI prism 3100 Genetic analyzer. The TS expression was analyzed by immunohistochemistry with using mouse anti-thymidylate synthase monoclonal antibody to the TS 106 clone. Results: Out of the ninety-nine patients, MSS/MSI-L was detected in 92 (92.1%) cases and 7 cases (7.1%) were MSI-H. A negative TS expression was found in 46 (46.5%) cases, a low TS expression was found in 33 (33.3%) and a high TS expression was found in 20 (20.2%). Out of 92 MSS/MSI-L patients, the number of patients with negative, low and high TS expressions were 46 (50%), 30 (32.6%) and 16 (17.4%), respectively. Out of the 7 MSI-H patients, the number of patients with negative, low and high TS expressions were 0 (0%), 3 (42.9%) and 4 (57.1%), respectively. The relationship between MSI-H and a high TS expression was statistically significant. Conclusion: Gastric cancer with MSI-H showed higher levels of a TS expression compared to the gastric cancer with MSS/MSI-L.

• The Korean Journal of Nuclear Medicine
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• v.38 no.6
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• pp.532-539
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• 2004

Purpose: There has been a renewal of interest in Macrophage migration inhibitory factor (MIF), especially correlation in pathogenesis of sepsis by many infectious diseases and in regulation of host inflammatory and immune response. We developed immunoradiometric assay (IRMA) to determine serum human MIF concentration. Materials and Methods: The IRMA system utilizes solid phase bound monoclonal anti-recombinant human MIF (rhMIF) antibody as a capture antibody, biotinylated polyclonal anti-rhMIF antibody as a detector antibody. We applied with rhMIF that concentration of standard solutions increased from 0 ng/ml to 100 ng/ml. We used $^{125}I$-streptavidin (SA) as radiotracer to determination of rhMIF concentration. Streptavidin was labeled with $^{125}I$ by Chloramine-T method and $^{125}I$-SA was purified by ultracentrifugation. $^{125}I$-SA stability was evaluated by ITLC analysis at $4^{\circ}C$ and room temperatures until 60days. To validate IRMA system for MIF, we experimented intra-assay and inter-assay coefficients of variation, recovery test and dilution test. Results: Radiolabeling yield of $^{125}I$-SA was 87% and purified $^{125}I$-SA retained above 99% radiochemical purity. $^{125}I$-SA showed above 93% stability in $4^{\circ}C$ until 60days that it is good for immunoradiometric assay as radiotracer. Plotted standard dose response curve showed that increased concentration of rhMIF linearly correlated (R2=0.99) with bound radioactivity of $^{125}I$-SA. The highest intra- and inter-assay coefficients of variation were 5.5% and 7.6%, respectively. The average of recovery of MIF in samples was 102%. In dilution test, linear response curves were obtained (R2=0.97). Conclusion: Radioimmunoassay using $^{125}I$-SA as radiotracer thought to be useful for the determination of serum MIF concentration, and further, its data will be used to evaluate the correlation between clinical significance and serum MIF concentration in patients with various inflammatory diseases.

• The Korean Journal of Nuclear Medicine
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• v.38 no.6
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• pp.498-505
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• 2004

Purpose: We compared captopril renal scintigraphic criteria for the diagnosis of renovascular hypertension by unilateral renal artery stenosis. Materials and Methods: The study group consisted of 24 patients (m/f : 16/8, age: $39{\pm}18$ years) with unilateral renal artery stenosis who underwent renal artery revascularization and captopril renal scintigraphy with $^{99m}Tc$-diethylenetriaminepentaacetic acid between May 1995 and April 2004. The blood pressure response was classified as cure/improvement or failure. We evaluated captopril-induced changes in relative function (BCfun) and renogram grade (0 to 5: 0=normal, and 5=renal failure pattern without measurable uptake) (CBren) and the difference of renograms between the normal and stenotic kidney on captopril scan (CNren). Results: light of 24 patients were cured and 11 improved and 5 patients were classified as failed revascularization. Significant predictors of a cure or improvement of blood pressure were younger age, stenosis by fibromuscular dysplasia or arteritis, BCfun, CBren and CNren. Areas under the receiver operating characteristic curve of age, BCfun, CBren and CNren were not significantly different. Positive and negative predictive values of predictors were 100% and 42% (age ${\leq}38$): 92% and 50% (BCfun ${\geq}1%$): 92% and 75% (CBren ${\geq}1$), and 90% and 60% (CNren ${\geq}1$), respectively. Conclusion: Captopril induced changes in renal function and renogram can reliably predict hypertension response to revascularization. Renogram pattern on captopril scan can diagnose renovascular hypertension without baseline data in patients with unilateral renal artery stenosis.

• Nuclear Medicine and Molecular Imaging
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• v.41 no.6
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• pp.530-537
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• 2007

Purpose: The aim of this study is to assess the specific patterns of regional cerebral blood flow (rCBF) in patients with the early stage of subcortical vascular dementia (SVaD) and Alzheimer's disease (AD) using Tc-99m HMPAO SPECT, and to compare the differences between the two conditions. Materials and Methods: Sixteen SVaD, 46 AD and 12 control subjects participated in this study. We included the patients with SVaD and AD according to NINCDS-ADRDA and NINDS-AIREN criteria. They were all matched for age, education and clinical dementia rating scores. Three groups were evaluated by Tc-99m HMPAO SPECT using statistical parametric mapping (SPM) for measuring rCBF. The SPECT data of patients with SVaD and AD were compared with those of normal control subjects and then compared with each other. Results: SPM analysis of the SPECT image showed significant perfusion deficits on the right temporal region and thalamus, left insula and superior temporal gyrus, both cingulate gyri and frontal subgyri in patients with SVaD and on the left supramarginal gyrus, superior temporal gyrus, postcentral gyrus and inferior parietal lobule, right fugiform gyrus and both cingulate gyri in AD compared with control subjects (uncorrected p<0.01). SVaD patients revealed significant hypoperfusion in the right parahippocampal gyrus with cingulated gyrus, left insula and both frontal subgyral regions compared with AD (uncorrected p<0.01). Conclusion: Our study shows characteristic and different pattern of perfusion deficits in patients with SVaD and AD, and these results may be helpful to discriminate the two conditions in the early stage of illness.

• Journal of Dental Rehabilitation and Applied Science
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• v.35 no.4
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• pp.214-219
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• 2019

Purpose: The aim of this study was to evaluate the correlation between inter-condylar width and inter-maxillary first molar width to present the criteria for prosthetic reconstruction of dental arch width in maxillary and mandibular fully edentulous patients. Materials and Methods: 120 Koreans (60 males and 60 females) who underwent the cone beam computerized tomography (Cone-beam CT) were selected. The Cone-beam CT images were analysed using Invivo 5.1. After reorientation of axis, inter-maxillary first molar width was measured by clicking both mesio-buccal cusp tip of maxillary first molar. And inter-condylar width was measured by clicking both middle points of condyles. The collected data were analysed with SPSS Version 20.0 and statistical significance of the correlation between inter-condylar width and inter-maxillary first molar width was verified by Pearson's correlation analysis. Results: The mean inter-condylar width of Korean was 105.9 mm, and that of male (108.3 mm) was statistically significantly wider than the female (103.4 mm). The inter-maxillary first molar width of Korean was 57.1 mm, and that of male (57.9 mm) was statistically significantly wider than the female (56.2 mm). Pearson's correlation analysis between inter-condylar width and inter-maxillary first molar width showed a Pearson correlation coefficient of 0.614 and statistically significantly positive correlation. Conclusion: Intercondylar width and inter-maxillary first molar width showed positive correlation and the average ratio of inter-condylar with and inter-maxillary first molar width was 1:0.54. Based on the results of this limited study, inter-condylar width can be used as a guide for setting up dental arch width in fully edentulous patient.

• 대한공업교육학회지
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• v.44 no.2
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• pp.28-46
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• 2019

The purpose of this study is to use as a basic data of establishing operating Course-based National Technical Qualification(CNTQ) support program by examining the educational needs for operating CNTQ of vocational school teachers, and to contribute to the vocational school settlement of CNTQ course. To achieve those purposes, this study drew 27 tasks performed by teachers operating CNTQ. Also, it surveyed the perceived importance and the performance. The findings of this study are as follows. First, it is showed that 'selection of qualification fields and confirmation of organization criteria, organization of educational training time by competency unit, organization of subjects and establishment of competency unit operating plan by grade and semester, selection of teaching materials, implementation of education and training, establishment of evaluation plan, implementation of evaluation, re-education and re-evaluation students with grades under 40%, guidance of paper evaluation, guidance of practical evaluation, guidance of interview evaluation' are the first priority tasks in the result of the need analysis. Second, it is indicated that 'application of external evaluation, guidance to retake an exam for failure' are the secondary priority tasks. According to these results, the following conclusions were made. First, it will be more positive effects if the educational needs in the next CNTQ support program include contents of the first priority tasks. Second, it is indicated that the priority of the educational needs for tasks of operating plan stages is commonly high. In particular, the highest ranking in the result means that it is completely supported from the first step on operating course. It is expected that the program which teachers on operating the course of similar qualification fields share each operating experience is effective. Third, the priority of the educational needs for external evaluation step ranked high. External evaluation has a different level of difficulty and a form of practical evaluation output according to qualification fields, so the method of guidance has to be different. It needs the program constructed by similar fields.

• Journal of the Korean Institute of Landscape Architecture
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• v.43 no.4
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• pp.15-26
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• 2015

The Daegu Metropolitan Transit Corporation Advisory Committee has chosen 5 styles of bridge-pier designs, including coating, graphic, planting, billboard and safety-facility style, based on the results of landscape simulations from a previous study. This study was conducted to investigate citizen's preferences and emotional images for each style of bridge-pier design, by aiming at the pilot urban landscape improvement section from Daebong Bridge in Suseong Gu to the crossroads near Dongseong Elementary School in Daegu Metropolitan City. The questionnaire was drawn up regarding the urban landscape improvement plans applied to the research area, and the questions were about citizens' perception of bridge-pier structures generated by constructing a light rail transit, important factors to consider when designing bridge piers, preferences for each style of bridge-pier design and emotional impact. 60.4% of the survey participants were found to perceive bridge-pier structures as unattractive, so it was necessary to improve them aesthetically. Regarding visual factors of bridge-pier designs, color was most important at 5.81, followed by form at 5.57. Regarding aesthetic component factors, harmony was most important at 6.07, followed by amenity at 6.00. In the survey participants' preference for each bridge-pier design, the graphic style was preferred most at 4.14, followed by the planting style. In emotional adjectives used for each bridge-pier design, the coating style, the safety-facility style and the non-treatment style showed similar results, and all of these styles were evaluated as artificial, lifeless and desolate. The graphic style and the billboard style showed different tendencies, depending on visual factors and aesthetic component factors applied to the graphic design used for these two bridge-pier styles. Since natural materials were used for the planting style, however, it showed high preference for such emotional images as natural and lively. The emotional adjective 'amiable' was found to affect citizens' preferences for each bridge-pier aesthetic improvement plan most, and it was also analyzed to have an effect on all the styles of bridge-pier designs. To improve the landscape of a light rail transit being constructed inside the urban area, this study quantitatively extracted citizens' preferences and emotional adjective for every style of bridge-pier design applied to the pilot urban landscape improvement section, and it is expected that the results of this study will be used as basic data to improve the landscape of bridge piers.