• Journal of Gastric Cancer
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• 제4권3호
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• pp.143-148
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• 2004

Purpose: To determine the clinical value of the Siewert classification for gastic-cancer patients in Korea, we evaluated and compared the clinicopathologic factors of type II and type III cancer. Materials and Methods: The medical records of 89 consecutive patients who had undergone surgery for an adenocarcinoma of the gastroesophageal junction (GEJ) at the Department of Surgery, Hanyang University Hospital, between Jun. 1992 and Dec. 2003 were reviewed retrospectively. Results: There were one patient with type I, 12 pateints with type II and 77 patients with type III. During the same period, 1,341 patients underwent surgery for a gastric carcinoma, so proportion of GEJ cancer being $6.6\%$. The median followup duration was 31 months (range: $2\∼135$ months), and the follow-up rate was $100\%$. Between type II and type III cancers, there were no significant differences in the clinicopathologic variables including age, sex, gross appearance, histologic type, depth of invasion, and pathologic stage. The longest diameter of the tumor was larger in type III ($6.1\pm2.1$ cm) than in type II ($3.9\pm1.1$ cm)(P=0.001). A total gastrectomy with Roux-en-Y esophagojejunostomy was done most frequently, while jejunal interposition was done in 3 cases of type II and 2 cases of type III. More than a D2 lymphadenectomy was done all cases. The numbers of dissected lymph nodes and metastatic lymph nodes in type II were 43.8 and 5.8 respectively, while they were 49.8 and 8.1 in type III, but the difference between the two groups were not statistically significant. The mean length of the proximal resection margin was $15\pm5$ mm in type II and $21\pm13$ mm in type III, but this difference was not statistically significanct. The time to recurrence after operation was 19.3 months in type II and 16.9 months in type III. The five-year survival rates of type II and III were $68.8\%\;and\;52.7\%$ respectively, but difference was not significant. Conclusion: There were no significant differences in the clinicopathologic variables, including survival rate, between type II and type III cancers in Korean patients According to these findings, it appears to be reasonable to classify type III cancer as a cardia cancer in a broad sense.

• Journal of Gastric Cancer
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• 제5권2호
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• pp.113-119
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• 2005

목적: 표준화된 술식으로 위절제술을 시행한 위암 환자를 대상으로 임상병리학적 특성, 특히 암세포의 림프관, 정맥 및 신경 침범 유무가 환자의 예후에 미치는 영향을 확인 하고자 하였다. 대상 및 방법: 1995년 1월부터 1999년 12월까진 만 5년간 영남대학교 의과대학 부속병원 외과에서 위암으로 진단되어 위절제를 시행받은 1,018명의 의무기록을 토대로 후향적 연구를 시행하였다. 통계는 chi-dquare test를 이용하고 예후 인자들은 Cox proportional hazards regression model을 사용한 다변량 분석을 통해 분석하였다. 생존율은 Kaplan-Meier 방법으로 5년 생존율을 구하고 log-rank test로 검정하였다. 유의 수준은 P < 0.05를 기준으로 하였다. 통계처리는 SPSS for Windows (Version 10.0, SPSS lnc, USA) 프로그램을 이용하였다. 결과: 각 임상병리학적 특성에 대한 단변량 분석 결과, 환자의 연령, 종양의 크기 및 위치, Borrmann형, 조직 분화도, 위절제술의 범위, 암의 위벽 침윤도, 림프절 전이 정도, 병기, 원격 전이 유무, 수술의 근치도 등이 유의하였으며, 이상의 유의한 인다들을 다변량 분석한 결과 암의 위벽 침윤도, 림프절 전이, 림프관 침범, 신경 침범 및 수술의 근치도가 독립적 예후 인자로서 유의하였다. 결론: 기존의 TNM 병기 분류법이 병의 진행 상태를 객관적으로 표현할 수 있고 기본적인 예후 인자로서 역할을 하지만, 병리조직학적 검사 소견에서 림프관 및 신경 침범 유무를 확인하는 것은 위암의 예후 판정에 추가적인 정보를 제공할 수 있을 것으로 기대한다.

• 대기
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• 제23권4호
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• pp.389-400
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• 2013

Chugugi and Wootaeck rainfall data of Gyeonggi Province from 1830 to 1893 were restored from the "Gaksadeungnok" that is the government records between the central government and the local during the Joseon Dynasty. The restored data periods were 27, 10, 9 and 14 years for Kwangju, Suwon, Ganghwa and Gaeseong, and the total number of restored data was 655 for the Chugugi and 427 for the Wootaek, respectively. The variation pattern of monthly rainfall by Chugugi was investigated and it showed that the monthly rainfall more than 300 mm was recorded 25 times with 18 times in July, 5 times in August and 3 times in June. The cases of more than 500 mm were also recorded 8 times with the maximum 787 mm at the Kwangju in July 1862, showing the similar pattern to Seoul. The monthly mean rainfall for the Gyeonggi Province were 259 mm in July, 204 mm in August and 121 mm in June, which were about one third of that of Seoul. The correlation analysis between the Chugugi and Wootaek data was carried out to derive the quantitative values of Wootaek observations. It revealed that 1 'Ri' of Wootaek observation was equal to approximately 1 'Chon (Chugugi unit)' or 20 mm, while 1 'Seo' was very variable between 2 and 6 'Boon (Chugugi unit)' with the median value approximately 3 'Boon' or 6 mm. Recalculated Wootaek data showed that the monthly rainfall in July, August, and June were 289 mm, 154 mm, and 124 mm, respectively. Through this study, some features of the rainfall variation pattern during 1830~1893 were figured out, and quantitative interpretation of Wootaek data became possible based on the restored rainfall data from the "Gaksadeungnok". Though many pages of the book have been lost during the last hundreds years, "Gaksadeungnok" is still very meaningful and of practical use, for it contains plenty of the local data throughout the whole country during the latter part of Joseon Dynasty. Therefore, further studies are strongly recommended on the restoration of climate related data and on the climatic tendency of 19th century of Korean peninsular.

• Toxicological Research
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• 제26권4호
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• pp.293-300
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• 2010

tert-Butyl acetate (TBAc) is an organic solvent, which is commonly used in architectural coatings and industrial solvents. It has recently been exempted from the definition of a volatile organic compound (VOC) by the Air Resources Board (ARB). Since the use of TBAc as a substitute for other VOCs has increased, thus its potential risk in humans has also increased. However, its inhalation toxicity data in the literature are very limited. Hence, inhalation exposure to TBAc was carried out to investigate its toxic effects in this study. Adult male rats were exposed to TBAc for 4 h for 1 day by using a nose-only inhalation exposure chamber (low dose, $2370\;mg/m^3$ (500 ppm); high dose, $9482\;mg/m^3$ (2000 ppm)). Shamtreated control rats were exposed to clean air in the inhalation chamber for the same period. The animals were killed at 2, 7, and 15 days after exposure. At each time point, body weight measurement, bronchoalveolar lavage fluid (BALF) analysis, histopathological examination, and biochemical assay were performed. No treatment-related abnormal effects were observed in any group according to time course. Based on those findings, the median lethal concentration ($LC_{50}$) of TBAc was over $9482\;mg/m^3$ in this study. According to the MSDS, the 4 h $LC_{50}$ for TBAc for rats is over $2230\;mg/m^3$. We suggested that this value is changed and these findings may be applied in the risk assessment of TBAc which could be beneficial in a sub-acute study.

• 경영과정보연구
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• 제34권2호
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• pp.193-206
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• 2015

본 연구에서는 기업의 대리비용이 판매관리비의 비대칭적 원가행태에 어떠한 영향을 미치는지를 살펴보고, 기업 지배구조가 대리비용이 판매관리비의 하방경직적 원가행태에 미치는 영향관계에 어떠한 조절효과를 보이는지를 분석해 보았다. 2007년부터 2012년까지 국내 유가증권 시장에 상장된 1,780개 제조기업을 바탕으로 다중회귀분석을 통해 실증 분석한 결과를 요약하면 다음과 같다. 첫째, 대리인 문제가 큰 기업의 경우 그렇지 않은 기업에 비해 판매관리비의 하방경직성은 증가하는 것으로 나타났다. 이는 경영자가 매출액이 하락하더라도 자신의 특권적 소비를 줄이지 않기 때문에 판매관리비의 하방경직적 원가행태가 증가된다고 해석할 수 있다. 둘째, 대리인 문제가 심각할 것으로 예상되는 기업을 대상으로 기업 지배구조가 판매관리비의 원가행태에 영향을 미치는 지를 분석한 결과, 좋은 기업 지배구조를 가지고 있는 기업의 경우 판매관리비의 하방경직적 원가행태가 완화되는 것으로 나타났다. 이는 경영자의 대리인 문제 통제에 효과적인 지배구조를 가진 기업일수록 대리인 문제에 기인한 판매관리비의 하방경직적 원가행태가 완화되는 것으로 해석할 수 있다. 본 연구는 대리인 문제의 크기가 판매관리비의 원가행태에 어떠한 영향을 미치며, 이런 영향관계에 기업지배구조가 조절효과를 가진다는 것을 실증적으로 규명해 보았다는 데 연구의 의의를 찾을 수 있다.

• 대한임상독성학회지
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• 제14권1호
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• pp.16-25
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• 2016

Purpose: Patients suffering from acute poisoning by different substances often visit the emergency department (ED) and receive various prognoses according to the toxic material and patients' condition. Hyperlactatemia, which is an increased blood lactate level that generally indicates tissue hypoperfusion, is commonly utilized as a prognostic marker in critically ill patients such as those with sepsis. This study was conducted to investigate the relationships between blood lactate and clinical prognosis in acute poisoned patients. Methods: This retrospective study was conducted from January 2013 to June 2014 at a single and regional-tertiary ED. We enrolled study patients who were examined for blood test with lactate among acute intoxicated patients. The toxic materials, patient demographics, laboratory data, and mortalities were also reviewed. Additionally, we analyzed variables including blood lactate to verify the correlation with patient mortality. Results: A total of 531 patients were enrolled, including 24 (4.5%) non-survivors. Patient age, Glasgow coma scale (GCS), serum creatinine (Cr), aspartate transaminase (AST), and serum lactate differed significantly between survivors and non-survivors in the binary logistic regression analysis. Among these variables, GCS, AST, and lactate differed significantly. The median serum lactate levels were 2.0 mmol/L among survivors and 6.9 mmol/L among non-survivors. The AUC with the ROC curve and odds ratio of the initial serum lactate were 0.881 and 3.06 (0.89-8.64), respectively. Conclusion: Serum lactate was correlated with fatalities of acute poisoning patients in the ED; therefore, it may be used as a clinical predictor to anticipate their prognoses.

• 생태와환경
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• 제34권4호통권96호
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• pp.267-276
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• 2001

수도권의 중심부를 가로지르는 한강의 하류수역은 조수의 영향을 받을 수 있는 하구의 상단부에 위치해 있다. 한강 하류수역은 한강종합개발사업의 일환으로 이루어진 준설과 수중보 건설에 의해서 강물이 정체되었으며, 또한 지천으로부터 유입되는 많은 오염물질에 의해서 식물플랑크톤의 대량 발생을 촉진할 수 있는 환경으로 변화되었다. 본 연구에서는 부영양한 한강 하류수역에서 식물플랑크톤의 1차생산을 측정하였으며, 더불어 내부생성유기물과 외부기원유기물을 산정하였다. 1차생산력은 C-14 uptake법과 P-I 모델법으로 측정하였다. 1차생산력의 범위는 $140{\sim}4,890\;mgC\;m^{-2}\;d^{-1}$ (중앙값 $1,865\;mgC\;m^{-2}\;d^{-1}$)이었으며, 국내의 부영양한 호수와 유사한 수준이었다. 식물플랑크톤의 생물량 변동은 봄철에 최대치를 보였으며, 유량의 변화와 관련이 있는 것으로 나타났다. 외부기원유기물은 여름철 흥수기를 제외한 연중 내내 지천을 통하여 유입되는 오염물질에 의해서 좌우되었다. 총 유기물 부하량에 대하여 식물플랑크톤의 1차생산이 차지하는 기여도는 40.9%로서, 유수 생태계로서는 높은 수준이었다.

• Journal of Chest Surgery
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• 제49권4호
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• pp.273-279
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• 2016

Background: The use of extracorporeal life support (ECLS) in the setting of cardiopulmonary resuscitation (CPR) has shown improved outcomes compared with conventional CPR. The aim of this study was to determine factors predictive of survival in extracorporeal CPR (E-CPR). Methods: Consecutive 85 adult patients (median age, 59 years; range, 18 to 85 years; 56 males) who underwent E-CPR from May 2005 to December 2012 were evaluated. Results: Causes of arrest were cardiogenic in 62 patients (72.9%), septic in 18 patients (21.2%), and hypovolemic in 3 patients (3.5%), while the etiology was not specified in 2 patients (2.4%). The survival rate in patients with septic etiology was significantly poorer compared with those with another etiology (0% vs. 24.6%, p=0.008). Septic etiology (hazard ratio [HR], 2.84; 95% confidence interval [CI], 1.49 to 5.44; p=0.002) and the interval between arrest and ECLS initiation (HR, 1.05 by 10 minutes increment; 95% CI, 1.02 to 1.09; p=0.005) were independent risk factors for mortality. When the predictive value of the E-CPR timing for in-hospital mortality was assessed using the receiver operating characteristic curve method, the greatest accuracy was obtained at a cutoff of 60.5 minutes (area under the curve, 0.67; 95% CI, 0.54 to 0.80; p=0.032) with 47.8% sensitivity and 88.9% specificity. The survival rate was significantly different according to the cutoff of 60.5 minutes (p=0.001). Conclusion: These results indicate that efforts should be made to minimize the time between arrest and ECLS application, optimally within 60 minutes. In addition, E-CPR in patients with septic etiology showed grave outcomes, suggesting it to be of questionable benefit in these patients.

• Tuberculosis and Respiratory Diseases
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• 제68권3호
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• pp.162-167
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• 2010

Background: To date, there are few data on the risk factors for severe cases and deaths associated with the 2009 pandemic H1N1 influenza A. Here, we describe the clinical and epidemiologic characteristics of patients hospitalized for pneumonia and identify those factors associated with the development of major complications (MC). Methods: We reviewed the medical records of 41 cases of pneumonia admitted to a university-affiliated tertiary hospital between Aug 26 and Dec 10, 2009, and who had confirmed H1N1 influenza A based on real-time reverse transcriptase-polymerase-chain-reaction assay. There were 7,962 patients that fit these criteria. We compared the clinical features and demographic characteristics of patients who developed MC to with those who did not develop MC. Results: During the study period, 10 patients developed MC (required admission to the intensive care unit, n=10; required ventilator therapy, n=6; death, n=4). Patients with MC were significantly older than those without MC and more frequently had underlying medical conditions (90.0% vs 41.9%, p-value <0.01). In the patients with developed MC, the median $PaO_2/FiO_2$ ratio of 230.0 (145.0~347.3) at admission and pneumonia severity index (PSI) score of 141.5 (88.3~158.5) were higher than patients without MC. However, no differences were observed in laboratory findings or in viral shedding between the 2 groups. Conclusion: In hospitalized pneumonia patients of 2009 H1N1 influenza, old age, a history of malignancy, initial hypoxemia, $PaO_2/FiO_2$ ratio, and PSI score appear to be risk factor significantly related to developing MC. These findings might be the basis to influence strategies for admitting patients to an intensive or intermediate care unit and for pre-emptive antiviral therapy.

• Asian Pacific Journal of Cancer Prevention
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• 제16권1호
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• pp.77-81
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• 2015

Background: The aim of the study was to determine whether the expression of baseline phosphorus (P) and magnesium (Mg) levels were prognostic in terms of stage and overall survival (OS) in newly diagnosed non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) patients. Materials and Methods: Retrospectively, 130 patients were selected at the time of diagnosis oflung cancer (100 with NSCLC and 30 with SCLC), before the initialization of any chemo-radiotherapy. The median age was 67 (range 29-92). IA, IB, IIA, IIB, IIIA, IIIB and IV stages were present in 3, 4, 19, 6, 25, 8, and 65 patients, respectively. After centrifugation, the levels of serum P and Mg were measured using the nephelometric method/ photometry and evaluated before any type of treatment. Results: Higher than normal levels of P were found in 127/130 patients, while only four patients had elevated Mg serum values. In terms of Spearman test, higher P serum values correlated with either stage (rho=- 0.334, p<0.001) or OS (rho=-0.212, p=0.016). Additionally, a significant negative correlation of Mg serum levels was found with stage of disease (rho=-0.135, P=0.042). On multivariate cox-regression survival analysis, only stage (p<0.01), performance status (p<0.01) and P serum (p=0.045) showed a significant prognostic value. Conclusions: Our study indicated that pre-treatment P serum levels in lung cancer patients are higher than the normal range. Moreover, P and Mg serum levels are predictive of stage of disease. Along with stage and performance status, the P serum levels had also a significant impact on survival. This information may be important for stratifying patients to specific treatment protocols or intensifying their therapies. However, larger series are now needed to confirm our results.