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Survival Rates after Operation for Gastric Cancer: Fifteen-year Experience at a Korea Cancer Center Hospital (위암 수술 후 생존율 분석: 원자력병원의 15년간 경험)

  • Park, Jong-Ik;Jin, Sung-Ho;Bang, Ho-Yoon;Paik, Nam-Sun;Moon, Nan-Mo;Lee, Jong-Inn
    • Journal of Gastric Cancer
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    • v.8 no.1
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    • pp.9-19
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    • 2008
  • Purpose: Gastric cancer is the most common malignant tumor in Korea. We reviewed the cases at our institution to identify the survival rates and clarify the prognostic factors of patients with gastric cancer. Materials and Methods: We conducted a retrospective study of 6,918 patients who had received a diagnosis of gastric cancer, and they underwent surgery at Korea Cancer Center Hospital during a 15-year period from 1991 to 2005. Results: The overall 5-year survival rate was 66.8%. The univariate analysis revealed that age, location of tumor, gross type of tumor, the histology according to the WHO classification, the Lauren classification, depth of invasion (T stage), lymph node metastasis (N stage), distant metastasis (M stage), the type of surgery, the UICC TNM stage, postoperative complications, adjuvant chemotherapy, lymphatic invasion, venous invasion and perineural invasion were the significantly different factors of the survival rates. The multivariate analysis revealed that age, Borrmann type 4, the histology according to the WHO classification, depth of invasion (T stage), lymph node metastasis (N stage), distant metastasis (M stage), the type of surgery, UICC TNM stage, postoperative complications, adjuvant chemotherapy and lymphatic invasion were the independent prognostic factors. Conclusion: We have shown a statistically significant association between the survival rates after operation for gastric cancer and the clinicopathologic factors. Early diagnosis of gastric cancer, appropriate surgeryand adjuvant therapy might improve the quality of life and the survival rates of gastric cancer patients.

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Diagnostic Video-Assisted Thoracic Surgery (진단목적의 비디오 흉강경 수술)

  • Baek, Hyo-Chae;Hong, Yun-Ju;Lee, Du-Yeon;Park, Man-Sil
    • Journal of Chest Surgery
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    • v.29 no.5
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    • pp.542-547
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    • 1996
  • All patients who underwent video-assisted thoracic surgery (VATS) for diagnostic purposes from Jan. 1992 to Aug. 1995 were reviewed. The total number of patients were 111 with 57 male and 54 female, and the mean age was 49 years (range 1 to 74). Multiple biopsies from more than one location were performed in 17 patients , pleural biopsies were performed In 49 patients, lung biopsies in 43 patients, mediastinal mass or Iymph node biopsies in 33 patients, and two pericardium biopsies and one dia- phragm biopsy, for a total of 128 biopsies. Seventeen pleural biopsy cases and one lung biopsy case underwent operation under local anesthesia , the rest were performed under general anesthesia. In patients who underwent lung biopsy, the mean age was 49.1 ye rs (range 22~ 73). The operating time was 40 to 170 minutes (mean 97), intravenous or intramuscular injection for pain control was required 0 to 22 times(mean 4.7), and chest tube was inserted from 1 to 26 days(mean 7). In all patients except two, a diagnosis was obtained from the biopsy and complication was encountered in one patient in whom intraoperative paroxysmal atrial tachycardia was detected. In 7 patients, a thorn- cotomy had to be done due to pleural adhesion or intraoperative bleeding, and 7 patients had postoperative complications associated with the chest tube. In the pleural biopsy group, the mean age was 49 years (range 17~ 74). The operating time was 25 to 80 minutes (mean 49), intravenous or intramuscular injection for pain control was needed 0 to 20 times (mean 3.6), and the chest tube was i.nserted for 0 to 67 days(mean 9.8). In all the patients, a diagnosis was possible. The chest tube was inserted for longer than 7 days in 11 patients. In the Iymph node biopsy roup, the mean age was 44.2 years (range 1 ~ 68). The operating time was )0 to 3)5 minutes(mean 105), pain control was required 0 to 15 times(mean 3.2), and a chest tube was kept in place for 1 to 36 days(mean 6.1). In one patient, a diagnosis was not possible and a chest tube was kept in place for longer than 7 days in 7 patients. In the multiple biopsy group, the mean age was 53.1 years(range 20~ 71). The operating time was 15 to 165 minutes(mean 85), and pain control was done from 0 to 17 times(mean 3.1). The chest tube was kept in place for 1 to 16 days (mean 7.9).

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MR Imaging Findings of Uterine Cervical Adenocarcinoma (자궁경부 선암종의 자기공명영상 소견)

  • 김종철
    • Investigative Magnetic Resonance Imaging
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    • v.2 no.1
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    • pp.113-119
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    • 1998
  • Purpose : Because adenocarcinomas of the uterine cervix have lower 5-year survival rate than squamous cell carcinomas due to early lymph node metastasis and local extension, scrutiny of lymph node metastasis and local extension by radiologic examination is necessary in case of clinically diagnosed or suspected adenocarcinomas. The purpose of this study is to evaluate whether there are specific findings of these tumors, compared with squamous cell carcinomas, through the analysis of magnetic resonance (MR) imaging findings. Materials and Methods : Of 21 pathologically proven cervical adenocarcinomas, MR imaging findings of 18 tumors (histologic staging : two Ib, four IIa, two IIb, one IIIa, and one IIIb) were retrospectively analyzed and compared with those of 40 wquamous cell carcinoma in consecutive patients as a control group. T1-wetighted and fast spin echo T2-weighted images were obtained on the axial and sagittal planes, using a 1.5-T MR scanner. The largest diameter, location, signal intensity and degree of contrast enhancement contour, shape and longitudinal extent of the tumor and associated findings on MR image were analyzed. Results : The largest diameters of cervical adenocarcinomas ranged from 0.8 to 4.1 cm(mean, 2.2 cm). Of 18 adenocarcinomas, nine were of endocervical type. All adenocarcinomas were isointense to surrounding cervical stroma on T1-weighted images and hyperintense(homogeneous in ten, inhomogeneous in eight) on fast spin echo T2-weighted images. Adenocarcinomas enhanced on contrast study in all patients (homogeneous in six, inhomogeneous in 12 with hyperintese enhnacing rim in two). Eight adenocarcinomas had smooth contours and ten had irregular ones. The shape of adenocarcinoma was irregular in eight patients, barrel shape in six, papillary/polypod in three, and nodular in one. All adenocarcinomas involved lower half of the uterine cervix and six tumors extended up to the upper half. Pelvic lymph nodes of more than 1.5cm in diameter in two adenocarcinomas pateints and no detectable small pelvic lymph nodes on MR imaging in one patient were pathologically positive. Hydrometra was associated in two adenocarcinomas patients, and hematometra in one patient. Compared with squamous cell carcinomas, more frequent MR findings of endocervical type and barrel shape in cervical adenocarcinomas were statistically significant. Conclusion : Cervical adenocarcinomas had more frequent MR findings of endocervical type and barrel shape, compared with wquamous cell carcinomas. Adenocarcinoma of the uterine cervix may be suspected on MR imaging, when a cervical carcinoma is of barrel shape along the endocervical canal and tends to involve lymth nodes in earlier stages.

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Analysis of 2-D Potential Problem with L-shape Domain by p-Convergent Boundary Element Method (p-수렴 경계요소법에 의한 L-형 영역을 갖는 2차원 포텐셜 문제 해석)

  • Woo, Kwang-Sung;Jo, Jun-Hyung
    • Journal of the Computational Structural Engineering Institute of Korea
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    • v.22 no.1
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    • pp.117-124
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    • 2009
  • The p-convergent boundary element method has been proposed to analyze two-dimensional potential problem on the basis of high order Legendre shape functions that have different property comparing with the shape functions in conventional boundary element method. The location of nodes corresponding to high order shape function are not defined along the boundary, called by nodeless node, similar to the p-convergent finite element method. As the order of shape function increases, the collocation point method is used to solve linear simultaneous equations. The collocation patterns of p-convergent boundary element method consist of non-symmetric hierarchial or symmetric non-hierarchical. As the order of shape function increases, the number of collocation point increases. The singular integral that appears in p-convergent boundary element has been calculated by special numeric quadrature technique and semi-analytical integration technique. The L-shape domain problem including singularity in the vicinity of reentrant comer is analyzed and the numerical results show that the relative error is smaller than $10^{-2}%$ range as compared with other results in literatures. In case of same condition, the symmetric p-collocation point pattern shows high accuracy of solution.

Mobility Support Scheme Based on Machine Learning in Industrial Wireless Sensor Network (산업용 무선 센서 네트워크에서의 기계학습 기반 이동성 지원 방안)

  • Kim, Sangdae;Kim, Cheonyong;Cho, Hyunchong;Jung, Kwansoo;Oh, Seungmin
    • KIPS Transactions on Computer and Communication Systems
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    • v.9 no.11
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    • pp.256-264
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    • 2020
  • Industrial Wireless Sensor Networks (IWSNs) is exploited to achieve various objectives such as improving productivity and reducing cost in the diversity of industrial application, and it has requirements such as low-delay and high reliability packet transmission. To accomplish the requirement, the network manager performs graph construction and resource allocation about network topology, and determines the transmission cycle and path of each node in advance. However, this network management scheme cannot treat mobile devices that cause continuous topology changes because graph reconstruction and resource reallocation should be performed as network topology changes. That is, despite the growing need of mobile devices in many industries, existing scheme cannot adequately respond to path failure caused by movement of mobile device and packet loss in the process of path recovery. To solve this problem, a network management scheme is required to prevent packet loss caused by mobile devices. Thus, we analyse the location and movement cycle of mobile devices over time using machine learning for predicting the mobility pattern. In the proposed scheme, the network manager could prevent the problems caused by mobile devices through performing graph construction and resource allocation for the predicted network topology based on the movement pattern. Performance evaluation results show a prediction rate of about 86% compared with actual movement pattern, and a higher packet delivery ratio and a lower resource share compared to existing scheme.

Incidence of Fever Following Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration

  • Kim, Seo Yun;Lee, Jin woo;Park, Young Sik;Lee, Chang-Hoon;Lee, Sang-Min;Yim, Jae-Joon;Kim, Young Whan;Han, Sung Koo;Yoo, Chul-Gyu
    • Tuberculosis and Respiratory Diseases
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    • v.80 no.1
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    • pp.45-51
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    • 2017
  • Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive diagnostic method for mediastinal and hilar lymphadenopathy. This study aimed to investigate the incidence of fever following EBUS-TBNA. Methods: A total of 684 patients who underwent EBUS-TBNA from May 2010 to July 2012 at Seoul National University Hospital were retrospectively reviewed. The patients were evaluated for fever by a physician every 6-8 hours during the first 24 hours following EBUS-TBNA. Fever was defined as an increase in axillary body temperature over $37.8^{\circ}C$. Results: Fever after EBUS-TBNA developed in 110 of 552 patients (20%). The median onset time and duration of fever was 7 hours (range, 0.5-32 hours) after EBUS-TBNA and 7 hours (range, 1-52 hours), respectively, and the median peak body temperature was $38.3^{\circ}C$ (range, $137.8-39.9^{\circ}C$). In most patients, fever subsided within 24 hours; however, six cases (1.1%) developed fever lasting longer than 24 hours. Infectious complications developed in three cases (0.54%) (pneumonia, 2; mediastinal abscess, 1), and all three patients had diabetes mellitus. The number or location of sampled lymph nodes and necrosis of lymph node were not associated with fever after EBUS-TBNA. Multiple logistic regression analysis did not reveal any risk factors for developing fever after EBUS-TBNA. Conclusion: Fever is relatively common after EBUS-TBNA, but is transient in most patients. However, clinicians should be aware of the possibility of infectious complications among patients with diabetes mellitus.

A Study on Evaluation Method of the Urban Railway Station Sign Based on Applying the Positive Guidance Technique - Focusing on the Suseo Station Transfer Passageway - (Positive Guidance 기법을 적용한 도시철도역사 안내표지 평가방법 연구 - 수서역 환승동선을 중심으로 -)

  • Kim, Hwang Bae;Kim, Hyun Ju;Lee, Sang Hwa
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.37 no.3
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    • pp.629-636
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    • 2017
  • Urban railway are the most widely used means of transportation in the metropolitan area. It is difficult to draw out problems through the quantitative analysis technique because most of the research results show that most of the guide signs are installed with many or few guide signs. In this study, we propose a method to evaluate the information load and proper installation location at the main decision point in the transfer passageway for Suseo Station by applying Positive Guidance. As a result of analyzing the information load using this technique, it is suggested that the necessary information should be provided centered on the copper node because it provides confusion of the users by providing the same information in the transfer line. It is necessary to obtain guidance on how to remove the sign (advertising, high ceilings, etc). The study will be regarded as a key for the basis and placement of the guidelines for determining the appropriateness of the in the future urban railway station sign guide.

Association of 8q24.21 rs10505477-rs6983267 Haplotype and Age at Diagnosis of Colorectal Cancer

  • Haerian, Monir Sadat;Haerian, Batoul Sadat;Rooki, Hassan;Molanaei, Saadat;Kosari, Farid;Obohhat, Maedeh;Hosseinpour, Parisa;Azimzadeh, Pedram;Mohebbi, Seyed Reza;Akbari, Zahra;Zali, Mohammad Reza
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.1
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    • pp.369-374
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    • 2014
  • Background: Colorectal cancer (CRC) is the fourth most common cause of cancer death in the world. Genetic variants in 8q24.21 including rs10505477 and rs6983267 have been hypothesized to be involved in susceptibility to CRC. This study aims to investigate the possible association between these loci and their haplotypes with CRC risk in Iranian population. Materials and Methods: Subjects were recruited from two hospitals in Tehran. The rs10505477 and rs6983267 polymorphisms were genotyped by TaqMan real time PCR using subject genomic DNA, extracted either from formalin-fixed, paraffin-embedded tissue of patients or from blood of the controls by standard methods. Results: A total of 715 subjects (380 CRC patients and 335 matched controls) were genotyped in this study. Allele and genotype analysis of the rs10505477 and rs6983267 polymorphisms by gender, age at diagnosis, tumor location, tumor grade, and tumor node metastasis (TNM) showed no significant association with CRC risk. There was a significant relationship between GG haplotype and susceptibility to age at diagnosis for both <60 and ${\geq}60$ (p=0.0005 and p=0.000004, respectively) and between GT and CRC in the age at diagnosis ${\geq}60$ (Table 3: p=0.031). The GG haplotype was less frequent in CRC patients with the age at diagnosis <60, but was more common in subjects with the age at diagnosis ${\geq}60$. Conclusions: Results of this study suggests that the rs6983267 and rs10505477 polymorphisms alone may not be relevant to CRC risk, but their GG haplotype plays a notable role in age at diagnosis of CRC in the Iranian population.

MICROSATELLITE INSTABILITY AND p53 GENE MUTATION IN ORAL SQUAMOUS CELL CARCINOMA (구강편평상피세포암 조직에서의 Microsatellite 불안정성 및 p53 유전자 돌연변이 분석)

  • Choi, Tae-Ho;Chung, Woon-Bok;Hong, Su-Hyung;Kim, Jin-A;Na, Sun-Oung;Jang, Hyun-Jung;Sohn, Yoon-Kyung;Kim, Chin-Soo;Kim, Jung-Wan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.4
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    • pp.337-344
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    • 2000
  • Germ-line mutations at DNA repair loci confer susceptibility to colon cancer in hereditary non-polypopsis colorectal cancer. Somatic loss of DNA mismatch repair gene has been reported in a large variety of other tumor types. Replication errors(RERs) judged by microsatellite instability(MSI) and its associated mutations have been recognized as an important mechanism in various tumor types. To investigate associations between MSI and oral squamous cell carcinoma, the frequency of MSI using 12 microsatellite markers were analyzed for the series of oral tumors. Of 17 tumors, 8 cases(47%) did not show instability at any of the 12 loci; 5(29%) showed instability at $2{\sim}3$ loci; and 4(24%) showed instability above 4 loci. The 4 cases showing widespread MSI did not differ from those without evidence of instability in terms of age at diagnosis, degree of differentiation, metastasis to lymph node, tumor location or the presence of mutations in the p53 tumor suppressor gene. DCC and D17S 796 were the most frequently detected in MSI analysis. There were no correlation between smoking and MSI frequency, instead, smoking was suggested to increase the mutation rate of p53 and development of oral carcinomas.

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Surgical Results for Perforated Gastric Cancer (천공성 위암의 수술 방법과 치료 결과)

  • Lee, Moon-Soo;Chae, Man-Kyu;Kim, Tae-Yun;Cho, Gyu-Seok;Kim, Sung-Yong;Baek-Moo-Jun;Chung-Il-Kwon;Park, Kyung-Kyu;Kim, Chang-Ho;Song-Ok-Pyung;Cho, Moo-Sik
    • Journal of Gastric Cancer
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    • v.2 no.2
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    • pp.85-90
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    • 2002
  • Purpose: Perforated gastric cancer (PGC) is rare and occurs in $1\∼4\%$ of all gastric cancers. Possible dissemination of tumor cells at the time of perforation of the gastric carcinoma has been a matter of concern. The intraoperative determination of what kind of operation should be done and how extensive the lymphnode dissection should be still remains controversial. The purpose of this study is to evaluate the factors influencing the survival and to determine the optimal treatment for PGC. Materials and Methods: A total of 42 patients were operated on for a perforated gastric carcinoma at Soonchunhyang University Chunan Hospital from 1983 to 2000. the age and the sexes of the patients, the location of perforation, the diameter of perforation, the histologic type of the tumor, the depth of wall invasion, the absence or presence of lymph node metastasis / distant metastasis, the stage of disease, the type of operation, and the outcomes were examined. Statistically significant differences were analyzed by using Fisher's exact test. Results: The stage distributions according to the UICC classification were 1 case of stage I, 6 cases of stage II, 17 cases of stage III, and 11 cases of stage IV. An emergency gastrectomy was done in 26 patients ($61.9\%$), with a 5-yr survival rate of $44\%$. The survival of patients was significantly influenced by the depth of wall invasion, the lymphnode metastasis, distant metastasis, the stage of disease, and the type of operation. Conclusions: an emergency gastrectomy is the treatment of choice for most patients with resectable PGC. Choosing more a optimistic surgical approach for potentially curative cases of PGC should be one way to increase the patient's survival rate.

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