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The Prognostic Significance of the Number of Resected Lymph Nodes in Gastric Cancer Patients (근치 절제술을 시행한 위암에서 절제림프절 수의 임상적 의의)

  • Kim, Se-Jin;Jang, You-Jin;Kim, Jong-Han;Park, Sung-Soo;Park, Seong-Heum;Kim, Seung-Ju;Mok, Young-Jae;Kim, Chong-Suk;Ahn, Hyong-Gin
    • Journal of Gastric Cancer
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    • v.9 no.4
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    • pp.246-255
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    • 2009
  • Purpose: The objectives of this study were to investigate the impact of the number of resected lymph nodes on the survival of gastric cancer patients who underwent curative resection, and to evaluate the cut-off values that can have an influence on survival on the tumor stage-stratified analysis. Materials and Methods: The subjects were 949 gastric cancer patients who underwent curative resection at Korea University Medical Center from 1992 to 2002. They were classified according to the depth of tumor invasion, and the influence of the number of resected lymph nodes on survival was investigated. The cut-off value for the number of resected lymph nodes was determined as the smallest value that showed a significant survival difference. Results: The tumor size, location, lymph node stage, the number of metastatic lymph nodes and the number of resected lymph nodes were significantly different according to the tumor stage. The average number of resected lymph nodes was about 39, and it showed linear correlation with the number of metastatic lymph nodes. On the Cox proportional hazard model, the cut-off values of the number of resected lymph nodes, as corrected by the number of metastatic lymph nodes, was 14 for all the patients, 15 for the pT1 patients, 28 for the pT2 patients and 37 for the pT3 patients, respectively. Conclusion: Retrieving a number of lymph nodes that is more than the cut-off value could improve the survival of gastric cancer patients. Surgeons should also make efforts to perform an exact and thorough D2 lymph node dissection. Therefore, we urge surgeons to perform D2 dissection and pathologists should examine an certain exact number of lymph nodes.

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Immunohistochemical Localization of Nerve Growth Factor, Glial Fibrillary Acidic Protein and Ciliary Neurotrophic Factor in the Forebrain of the Developing Mongolian Gerbil (발생중인 Mongolian gerbil의 전뇌에서 NGF, GFAP 및 CNTF의 분포)

  • Park, Il-Kwon;Lee, Kyoug-Youl;Song, Chi-Won;Kwon, Hyo-Jung;Park, Mi-Sun;Lee, Mi-Young;Jeong, Young-Gil;Lee, Chul-Ho;Ha, Kwon-Soo;Lee, Kang-Yi;Kim, Moo-Kang
    • Korean Journal of Veterinary Research
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    • v.42 no.2
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    • pp.137-146
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    • 2002
  • The immunohistochemical localization of the nerve growth factor (NGF), glial fibrillary acidic protein (GFAP) and ciliary neurotrophic factor (CNIF) in the developing Mongolian gerbil forebrain was investigated by the immunohistochemical and electron microscopy methods. Generally, the NGF specifically recognizes the neurons, the GFAP does the glia, and the CNIF does the motor neurons. This study demonstrates the location of the NGF, GFAP and CNTF in the developing Mongolian gerbil from the embryonic days 17 (E17) to the postnatal weeks 3 (PNW 3). The NGF was localized at E19 in the olfactocy bulb and the cerebral cortex, expanded to the hippocampus, and the diagonal bond from the late prenatal period to PNW 3. GFAP was observed in the lateral ventricle and the third ventricle at E17, projected into the cerebral cortex at E19. The GFAP was observed to have the largest numbers in several parts of the forebrain at the postnatal days 2 (PND2), while the most numerous CNTF was observed at PNW 2. The CNTF-IR cells were observed only in the postnatal days and were found in the olfactory bulb, cerebral cortex both neuron and neuroglia at PND3. Electron microscopy showed that the NGF, GFAP and CNTF were not related to any connections with any particular subcellular structure. These results suggest that NGF, GFAP and CNTF be related to the neuron and neuroglia at the prenatal and postnatal stages in the developing Mongolian gerbil.

A Study on the Health Care Satisfaction and Attitude of Elementary School Students - by the presence or absence of nurse teacher - (초등학생의 보건관리 만족도와 태도에 관한 연구 - 양호교사 유무를 중심으로 -)

  • Park, Dong-Kwon;Park, Young-Soo
    • The Journal of Korean Society for School & Community Health Education
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    • v.1 no.2
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    • pp.49-71
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    • 2000
  • The purpose of this study was to serve as a basis for school health care of better quality, by making a comparative analysis of the health care satisfaction and attitude of elementary school students in consideration of their general characteristics and the presence or absence of nurse teacher. The subjects in this study were 919 selected six graders in 16 elementary schools in the city of Tongduchun, Koyang and Euijungbu, Yangju-kun and Yeunchun-kun. A survey was conducted with questionnaire designed for measurement of health care satisfaction and attitude. As a result of analyzing the data collected from June 1 through 15, 2000, the conclusions were as follows. 1) As for the general characteristics of the students investigated, the subjects included 513 boys(55.8%) and 406 girls(44.2%). The schools where 390(42.4%) students attended were located in municipal area, and the schools where 529(57.6%) students attended were located in kun area. 608(66.2%) students had a nurse teacher at their schools, while 311(33.8%) students had no nurse teacher. 498(54.2%) had an experience to use the health room this year, but 421(45.8%) had no such an experience. Their mean school life satisfaction was scored $3.42{\pm}.71$, above the average. And their health condition was rated $3.81{\pm}.87$, which implied they tended to be in good health. 2) The mean satisfaction at the health room operation was scored $3.33{\pm}.71$, above the medium level. What they were most satisfied with($4.02{\pm}1.08$) was, among the health room facilities, that there were beds. But they expressed the least satisfaction($2.83{\pm}1.17$) at the location of health room. The presence or absence of nurse teacher made a significant difference to their satisfactionat health room operation, because the students in schools with nurse teacher showed greater satisfaction($3.42{\pm}.72$) than the others in schools with no nurse teacher did($3.15{\pm}.66$). 3) Concerning their attitude to use the health room in case of disease or accident occurrence, a lot of students in schools with a nurse teacher, who had ever suffered from indigestion, headache or traumatic injury, used the health room. In schools with no nurse teacher, there was a tendency to talk to their class teachers(p<.001). The recognition of the necessity for health counseling was generally on a medium level. The counselor whom they wanted to discuss health problem with was family or friend in the largest cases. Few students discussed with class teachers in case there was a nurse teacher in school. Instead, some of them discussed with friend, family or nurse teacher, and there was a significant difference between them(p<.001). 4) The mean satisfaction at health, sanitation and environmental management was rated $3.20{\pm}.90$, above the average. The classroom lighting gave them the best satisfaction with $3.67{\pm}1.07$, but the satisfaction at toilet cleanness and disinfection was not good with $2.83{\pm}1.19$. By the presence or absence of nurse teacher, those who had a nurse teacher expressed better satisfaction at water supply facilities including hot water than the others who had no nurse teacher did(p<.001). But no significant difference was observed in the other items. 5) The health education satisfaction was rated $3.19{\pm}.99$, which was on a medium level. By item, the mean satisfaction level was $3.36{\pm}1.19$ at nurse teacher's explanation about treatment, $3.13{\pm}1.15$ at the frequency of health education, and $3.08{\pm}1.16$ at the explanation on the cause of disease. By the presence or absence of nurse teacher, the students with nurse teacher showed significantly better satisfaction at every factor0(p<.001). 6) Regarding health education attitude, their recognition of the need for school health education was scored $3.89{\pm}.96$. Those who had a nurse teacher felt it more necessary($3.96{\pm}.92$), yet the others who had no nurse teacher felt its necessity a little less($3.74{\pm}1.01$). The most preferred thing for them to learn in health education was first aid, followed by sex education, obesity prevention, safety accident prevention in school and outdoors, smoking-related health, good use of leisure time, and environmental pollution cause in the order named. According to the presence or absence of nurse teacher, there was a significant difference in sex education(p<.01), but no significant disparities were found in the other factors. The most preferred person who would offer health education was a lecturer from the outside(45.8%) and nurse teacher(45.4%). Their preference for class teacher as a person in charge of health education was just 8.8%. But the presence or absence of nurse teacher didn't produce any differences to their preference for a person in charge of health education.

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Surgical Approaches to the Middle Cranial Base Tumors (중두개와저 종양에 대한 수술적 치료)

  • Kim, Il Seub;Rha, Hyung Kyun;Lee, Kyung Jin;Cho, Kyung Keun;Park, Sung Chan;Park, Hae Kwan;Cho, Jeung Ki;Kang, Jun Ki;Choi, Chang Rhack
    • Journal of Korean Neurosurgical Society
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    • v.30 no.9
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    • pp.1079-1085
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    • 2001
  • Objective : We analysed various surgical approaches and surgical results of 28 middle cranial base tumors for the purpose of selecting optimal surgical approach to the middle cranial base tumor. Methods : In this retrospective review, 28 patients, including 16 meningioma, 6 trigeminal neurinoma, 2 pituitary adenoma, 2 craniopharyngioma, 1 facial neurinoma, and 1 metastatic tumor, underwent surgical treatment using skull base technique. Of theses, 16 tumors were mainly confined to middle cranial fossae, 5 tumors with extension into both anterior and middle fossa, and 7 tumors with extension into both middle and posterior fossa. Tumors that confined to the middle cranial fossa or extended into the anterior cranial fossa were operated with modified pterional, orbitozygomatic or Dolen'c approach, and tumors that extended into the posterior cranial fossa were operated with anterior, posterior or combined transpetrosal approach. Completeness of tumor resection, surgical outcome, postoperative complication, and follow up result were studied. Results : Total tumor removal was achieved in 9 tumors of 10 tumors that did not extended to the cavernous sinus, and was achieved in 7 tumors of 8 tumors that extended to the lateral wall of the cavernous sinus. Of 10 tumors that extended to the venous channel of the cavernous sinus, only 2 were removed totally. Surgical outcome was excellent in 14 patients, good in 10, fair in 2 and poor in 2. There were no death in this series. Dumbell type tumor which extended into both middle and posterior fossae showed tendency of poor prognosis as compared with tumors that confined middle cranial fossa and extended into both anterior and middle cranial fossa. Postoperative dysfunctions were trieminal hypesthesia in 3, oculomotor nerve palsy in 2, abducens nerve palsy in 2, hemiparesis in 2, cerebellar sign in 1, facial palsy in 1 and hearing impairment in 1. Conclusion : Based on our findings and a review of the literature, we conclude that, when selecting the surgical approach to the middle cranial fossa tumors, the most important factors to be considered were exact location of the tumor mass and existence of the cavernous sinus invasion by tumor mass. We recommend modified pterional or orbitozygomatic approach in cases with tumors located anterior and middle cranial base, without cavernous sinus invasion. In cases with tumors invading into cavernous sinus, we recommend Dolen'c or orbitozygomatic approach. And in lateral wall mass and the cavernous sinus, it is preferred to approach the tumor extradurally. For the tumor involing with middle fossa and posterior fossa(dumbell type) a combined petrosal approach is necessary. In cases with cavernous sinus invasion and internal carotid artery encasement, we recommend subtotal resection of the tumor and radiation therapy to prevent permanent postoperative sequele.

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Development of Artificial Pulmonary Nodule for Evaluation of Motion on Diagnostic Imaging and Radiotherapy (움직임 기반 진단 및 치료 평가를 위한 인공폐결절 개발)

  • Woo, Sang-Keun;Park, Nohwon;Park, Seungwoo;Yu, Jung Woo;Han, Suchul;Lee, Seungjun;Kim, Kyeong Min;Kang, Joo Hyun;Ji, Young Hoon;Eom, Kidong
    • Progress in Medical Physics
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    • v.24 no.1
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    • pp.76-83
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    • 2013
  • Previous studies about effect of respiratory motion on diagnostic imaging and radiation therapy have been performed by monitoring external motions but these can not reflect internal organ motion well. The aim of this study was to develope the artificial pulmonary nodule able to perform non-invasive implantation to dogs in the thorax and to evaluate applicability of the model to respiratory motion studies on PET image acquisition and radiation delivery by phantom studies. Artificial pulmonary nodule was developed on the basis of 8 Fr disposable gastric feeding tube. Four anesthetized dogs underwent implantation of the models via trachea and implanted locations of the models were confirmed by fluoroscopic images. Artificial pulmonary nodule models for PET injected $^{18}F$-FDG and mounted on the respiratory motion phantom. PET images of those acquired under static, 10-rpm- and 15-rpm-longitudinal round motion status. Artificial pulmonary nodule models for radiation delivery inserted glass dosemeter and mounted on the respiratory motion phantom. Radiation delivery was performed at 1 Gy under static, 10-rpm- and 15-rpm-longitudinal round motion status. Fluoroscpic images showed that all models implanted in the proximal caudal bronchiole and location of models changed as respiratory cycle. Artificial pulmonary nodule model showed motion artifact as respiratory motion on PET images. SNR of respiratory gated images was 7.21. which was decreased when compared with that of reference images 10.15. However, counts of respiratory images on profiles showed similar pattern with those of reference images when compared with those of static images, and it is assured that reconstruction of images using by respiratory gating improved image quality. Delivery dose to glass dosemeter inserted in the models were same under static and 10-rpm-longitudinal motion status with 0.91 Gy, but dose delivered under 15-rpm-longitudinal motion status was decreased with 0.90 Gy. Mild decrease of delivered radiation dose confirmed by electrometer. The model implanted in the proximal caudal bronchiole with high feasibility and reflected pulmonary internal motion on fluoroscopic images. Motion artifact could show on PET images and respiratory motion resulted in mild blurring during radiation delivery. So, the artificial pulmonary nodule model will be useful tools for study about evaluation of motion on diagnostic imaging and radiation therapy using laboratory animals.

Studies on the establishment and characteristics of habitat use of muskrat(Ondrtra zibethicus) in South Korea (사향쥐(Ondrtra cuniculus)의 정착 및 서식지 이용에 관한 연구)

  • Kim, Young-Chae;Hong, Sun Hee;Lee, Changwoo;Kim, Areum;Park, Heebok;Park, Su-Gon;Kim, Minhan;Lee, Do-Hun
    • Korean Journal of Environmental Biology
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    • v.38 no.1
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    • pp.1-15
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    • 2020
  • This study was conducted to determine whether invasive muskrats settle in the natural ecosystem of Korea. The study also aimed to provide information on the selection of target areas, basic behavioral characteristics, and habitat use-related data, all of which are essential for effective management strategy establishment and site management. To this end, a trend in international muskrat management was identified to examine the management direction according to the settlement stage. We also secured the location of 72 domestic farmers and classified five regions in Gyeonggi-do, Chungcheongnam-do, Gyeongsangbuk-do, and Sejong Special Self-governing City into regions with high potential for natural leakage to raise the need for a quick survey. We determined that muskrats successfully settled in the natural ecosystem of Korea, based on the fact that we consistently identified a muskrat habitat at the same point for three years, from 2016 to 2018, the age of the captured population was estimated to be 1.2 years, and there had been no additional make-up factors near the habitat since 2012. The muskrats that settled in Korea showed a small home range of 0.0027 ㎢ (MCP 95%) and were estimated to show regular mobility before Spring and Autumn. Also, the areas where the muskrat habitat was observed had a high level of habitat environment disturbance and their ecological and food intake characteristics reflected that disturbance. Muskrat traces were high in hydrophyte vegetation, which can be used as a hideout in open waters and where the growth of both floating leaved plants and floating plants are prevalent. Since international invasive muskrats have already settled in the domestic ecosystem and there is concern about their proliferation in the future, the government must consider a preemptive response and scientific management.

Primary Radiation Therapy of Malignant Salivary Gland Tumors by Conventional Megavoltage Irradiation -Korea Cancer Center Hospital- (악성 타액선 종양의 방사선 치료 성적에 대하여 -원자력 병원의 10년 경험 ($1975.1{\sim}1984.12$)-)

  • Cho Chul Koo;Koh Kyoung Hwan;Yoo Seong Yul;Park Young Hwan;Park Woo Yoon;Shim Young Sang;Oh Kyung Kyoon
    • Radiation Oncology Journal
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    • v.8 no.1
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    • pp.35-43
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    • 1990
  • Retrospective analysis of survival rates was undertaken in the patients of 58 cases treated with conventional radiation therapy for malignant salivary gland tumors between January 1975 and December 1984 in Korea Cancer Center Hospital (KCCH). They were patients whose long-term follow-up was possible and who had refused surgery or had had recurrences postoperatively. Out of 58 patients, 25 patients ($43.1\%$) had mucoepidermoid carcinomas and 24 patients ($41.3\%$) adenoid cystic carcinoma. Total actuarial survival rates at 5 years and 10 years were $68.2\%\;and\;31.8\%$ respectively, but disease-free survival rates, $43.2\%\;and\;13.0\%$, respectively. According to TNM stage, the survival rates at 5 years were $86.5\%$ in $T_1,\;40.0\%\;in\;T_2+T_3,\;and\;0\%\;in\;T_4$. In terms of histologic types, 5 years disease-free survival rate of adenoid cystic carcinomas ($40.1\%$) was lower than that of mucoepidermoid carcinomas ($49.8\%$) but overall survival rate ($77.3\%$) was much higher than that of mucoepidermoid carcinomas ($51.5\%$). There-fore, we concluded that the patients, who had had disease after failure of treatment, could survive during a certain period of time and their alive times were 2 years on the average. There was a difference in survival rates in the mucoepidermoid carcinomas in terms of histological grade of differentiation and it was a arbiter in prognosis: 5 YSR of low-grade was $78.8\%$ and higher 2 times than that of high-grade. There was no difference in survival rates according to location and sex. The number of patients having minor salivary gland tumors was 6 cases and their actuarial 5 YSR was $32.3\%$. Consequently, prognostic factors which influence the survival rates of patients with malignant salivary gland tumors are thought to be 1) histological subtypes 2) T and N staging (AJCC) 3) histological grade, especially in mucoepidermoids.

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Consideration on Measured Patients Dose of Three-Dimensional and Four-Dimensional Computer Tomography when CT-Simulation to Radiation Therapy (방사선치료를 위한 CT 검사 시 3DCT와 4DCT에 대한 피폭선량 고찰)

  • Park, Ryeong-Hwang;Kim, Min-Jung;Lee, Sang-Kyu;Park, Kwang-Woo;Jeon, Byeong-Cheol;Cho, Jeong-Hee;Yoo, Beong-Gyu;Lee, Jong-Seok
    • Journal of radiological science and technology
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    • v.34 no.4
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    • pp.341-349
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    • 2011
  • This study was to measure the patient dose difference between 3D treatment planning CT and 4D respiratory gating CT. Study was performed with each 10 patients who have lung and liver cancer for measured patient exposure dose by using SOMATON SENSATION OPEN(SIMENS, GERMANY). CTDIvol and DLP value was used to analyze patient dose, and actual dose was measured in the location of liver and kidney for abdominal examination and lung, heart and spinal cord for chest examination. Rando phantom were used for the experiment. OSLD was used for in-vitro and in-vivo dosimetry. Increasing overall actual dose in 4D respiratory gated CT-simulation using OSLD increase the dose by 5.5 times for liver cancer patients and 6 times for lung cancer patients. In CT simulation of 10 lung cancer patients, CTDIvol value was increased by 5.7 times and DLP 2.4 times. For liver cancer patients, CTDIvol was risen by 3.8 times and DLP 1.6 times. The accuracy of treatment volume could be increased in 4D CT planning for position change due to the breaths of patient in the radiation therapy. However, patients dose was increased in 4D CT than 3D CT. In conclusion, constant efforts is required to reduce patients dose by reducing scan time and scan range.

Current Regional Cultural Situation and Evaluation of Grain Characteristics of Korean Wheat II. Grain Characteristics Collected in Domestic Wheat Cultivar Grown in Korea (국산밀 품질 향상을 위한 지역별 재배 현황 및 원맥 특성 평가 II. 농가 수집 원맥 특성 평가)

  • Kim, Kyeong-Hoon;Kang, Chon-Sik;Seo, Yong-Won;Woo, Sun-Hee;Heo, Moo-Ryong;Choo, Byung-Kil;Lee, Choon-Kee;Park, Kwang-Geun;Park, Chul Soo
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.58 no.3
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    • pp.239-252
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    • 2013
  • Agronomic characteristics and grain properties of Korean wheat of 175 farmers in nationwide for two years, 2010/2011 and 2011/2012, were evaluated to support basic data for improving grain quality of Korean wheat and enhancing Korean wheat consumption. Agronomic characteristics, including culm length, spike length, number of $spike/m^2$ and rate of off-type plant, and grain properties, including 1000 kernel weight, test weight, moisture, ash and protein content, were influenced by year and location. Number of $spike/m^2$, test weight, moisture, ash and protein content of wheat cultivated in 2011 were higher than those of 2012 and culm length, spike length, rate of off-type plant and 1000 kernel weight of 2012 were higher than those of 2011. Wheat cultivated in southern part of Korea showed higher culm length and 1000 kernel weight and lower test weight than those of northern part of Korea. Spike length, number of $spike/m^2$ and test weight were reduced by additional fertilization after mid of March, although there was no significant difference between date of additional fertilization and grain properties. Cultivated wheats in Jeollabuk-do showed lower ash content and higher protein content than those of other provinces and cultivated wheats in Jeollanam-do exhibited higher ash content than that of other provinces. As amount of fertilization increased, culm length, 1000 kernel weight and protein content increased and spike length and ash content were decreased, although date of additional fertilization did not effect on agronomic characteristics and grain properties. Amount of fertilization was positively correlated with 1000 kernel weight and protein content (r = 0.159, P < 0.05 and r = 0.212, P < 0.01, respectively) and was negatively correlated with ash content (r = -0.185, P < 0.05). Thousand kernel weight was negatively correlated with ash content (r = -0.226, P < 0.01) and positively correlated with protein content (r = 0.207, P < 0.01). Ash content increased as test weight and culm length decreased and 1000 kernel weight was influenced by culm and spike length (r = 0.397, P < 0.001 and r = -0.205, P < 0.01, respectively).

Clinical Investigation of Recurrent Pneumonia in Adults - Analysis of Patients From Hallym University Medical Center - (성인 재발성 폐렴에 대한 임상적 고찰 - 한림대학교 의료원 내원 환자를 대상으로 -)

  • Eom, Kwang-Seok;Jeon, Gang;Shin, Taerim;Jang, Seung Hun;Bahn, Joon-Woo;Lee, Jae Young;Park, Yong Bum;Kim, Cheol Hong;Jeon, Man-Jo;Park, Sang Myeon;Kim, Dong Gyu;Lee, Myung Goo;Hyun, In-Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.1
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    • pp.47-54
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    • 2004
  • Background : Recurrent pneumonia in adults is not uncommon. However, there is no domestic data about recurrent pneumonia in adults. Therefore, we investigated the associated diseases and clinical findings of recurrent pneumonia in adults. Methods : Among 5513 patients who were treated in five teaching hospitals of Hallym medical center?over a 5-year period, we retrospectively reviewed the medical records of the 58 who were compatible with diagnostic criteria of recurrent pneumonia. Results : The number of patients with recurrent pneumonia was 58 (1.05%, 58/5513) during the 5 years. Thirtyseven patients were male and 21 were female. Mean age was 66.4 (${\pm}14.9$) years. Median interval between each pneumonic episode was 18.5 months. Associated diseases were 25 cases of respiratory diseases, 13 of heart diseases, 13 of diabetes mellitus, 7 of lung malignancies, 11 of malignancies other than lung, 7 of neurologic disease, and 8 of miscellaneous diseases. Three cases had no underlying illness. Of the 8 cases with 2 or more times of recurrence, 4 were associated with respiratory diseases, 2 with aspiration pneumonia due to neurologic diseases, 1 with heart disease and 1 with no underlying illness. Recurrent pneumonic episodes affecting the same location were 30 of the total recurrent pneumonic episodes (30/67, 47.8%) and common associated diseases were respiratory diseases including lung malignancies. The etiology of recurrent pneumonia was Streptococcus pneumoniae, methicillinresistant Staphylococcus aureus, Pseudomonas aeruginosa, Klebsiella pneumoniae, atypical organisms, etc. Conclusion : Recurrent pneumonia in adults had a low incidence rate compared with children, but most cases had associated illness. Respiratory diseases including lung cancer were the most common associated illness of recurrent pneumonia.