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Clinicopathological Features and Prognostic Factors for Patients with Clinical T4 Gastric Cancer that Underwent Combined Resection of Invaded Organs (위암의 주위 장기 침윤으로 합병 절제를 실시한 환자의 병리학적 병기 및 예후)

  • Byun, Gun-Young;Park, Joong-Min;Kim, He-Il;Kim, Jong-Han;Park, Sung-Soo;Kim, Seong-Ju;Mok, Young-Jae;Kim, Chong-Suk
    • Journal of Gastric Cancer
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    • v.7 no.3
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    • pp.117-123
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    • 2007
  • Purpose: The surgical treatment of gastric cancer that invades adjacent organs is a radical gastrectomy with combined resection including the adjacent organs or a palliative operation by performing either a gastrojejunostomy or gastrectomy. However, since it is impossible to determine the exact stage of the cancer, either T or N, in the case of palliative surgery, it is inappropriate to predict patient prognosis. This study analyzes the prognoses for patients whose final TNM stages are determined by a combined resection performed due to macroscopical infiltration into the adjacent organs. Materials and Methods: Of 2,452 patients that underwent surgery for gastric cancer at our hospital from 1983 to 2002, we evaluated 102 patients where a combined resection was performed because direct infiltration into the adjacent organs was discovered. Results: Univariate analysis showed that the survival rate differed by the depth of invasion into the gastric walls, the degree of lymph node metastasis, distant metastasis, pathological TNM stage, surgical curability, the location of tumor, and histological differentiation. By multivariate analysis, it was found that the surgical curability, the location of the tumor and the degree of lymph node metastasis were independent prognostic factors. Conclusion: It is suggested that even when infiltration into adjacent organs is suspected, radical surgery should be performed as to allow a prediction of prognosis through an exact determination of disease stage, and to improve the survival rate.

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Pledget as a Useful Substitute for a Knot in Intracorporeal Continuous Gastrointestinal Suturing (복강 내 위장관 연속 손바느질에서 매듭 대용으로서의 Pledget의 유용성)

  • Kim, Jin-Jo;Song, Kyo-Young;Kim, Sung-Keun;Jun, Kyong-Hwa;Chin, Hyung-Min;Kim, Wook;Jeon, Hae-Myung;Park, Cho-Hyun;Park, Seung-Man;Lim, Keun-Woo;Park, Woo-Bae;Kim, Seung-Nam
    • Journal of Gastric Cancer
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    • v.7 no.3
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    • pp.146-151
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    • 2007
  • 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.

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The Anisotropic Mechanical Characteristics of the Metamorphic Rocks Distributed in the Samkwang-Mine Area, Cheongyang, Chungnam (충남 청양군 운곡면 일원에 분포하는 편마암의 강도이방성 특성 - 점재하강도지수와 일축압축강도의 관계를 중심으로 -)

  • 배대석;송무영;김경수
    • The Journal of Engineering Geology
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    • v.1 no.1
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    • pp.54-67
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    • 1991
  • In geological media with anisotropic properties, the strength anisotropy in intact rock is the most important issue in engineering aspects. Point-ioad(P/L) strength test designed to estimate the uniaxial compressive strength(${\sigma}_c$) can be used to evaluate the anisotropic strength characteristics of rocks. The relationship between ${\sigma}_c$ and P/L strength indices(I$_s$), obtained from the banded gneisses distributed in the Cheongyang area, varies depend mainly on the dip angle($\beta$) of foliation. The axial P/L strength indicies(I$_{sa}$) decreases with the increment of $\beta$, whereas diametral P/L strength indices(I$_{sa}$) increase with it. However, the ${\sigma}_c$ decreases with the increments of $\beta$ below about 40$^{\circ}$, but it increases with the increments of $\beta$ over about 40$^{\circ}$ in general. The correlation between ${\sigma}_c$ and I$_s$ suggests that ${\sigma}_c$ is related to the Isa withing low angle($\beta$<40$^{\circ}$) and the I$_{sd}$ within high angle ($\beta$>40$^{\circ}$), respectively. The ratios of I$_s$ to ${\sigma}_c$ are obtained as 11 to 14 in the the gneisses in the study area. The ratio of 24, which is generally adopted value, cannot always be truthworth to the gneisses in the study area. The ratio for the dykes, however, show a good correlation as 21 to 24.5 and, the value of 24 can be used for a homogeneous and isotropic materials such as dykes.

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Study on the calibration phantom and metal artifacts using virtual monochromatic images from dual energy CT (듀얼 에너지 CT의 가상 단색 영상을 이용한 영상 교정 팬텀과 금속 인공음영에 관한 연구)

  • Lee, Jun seong;Lee, Seung hoon;Park, Ju gyung;Lee, Sun young;Kim, Jin ki
    • The Journal of Korean Society for Radiation Therapy
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    • v.29 no.1
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    • pp.77-84
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    • 2017
  • Purpose: To evaluate the image quality improvement and dosimetric effects on virtual monochromatic images of a Dual Source-Dual Energy CT(DS-DECT) for radiotherapy planning. Materials and Methods: Dual energy(80/Sn 140 kVp) and single energy(120 kVp) scans were obtained with dual source CT scanner. Virtual monochromatic images were reconstructed at 40-140 keV for the catphan phantom study. The solid water-equivalent phantom for dosimetry performs an analytical calculation, which is implemented in TPS, of a 10 MV, $10{\times}10cm^2$ photon beam incident into the solid phantom with the existence of stainless steel. The dose profiles along the central axis at depths were discussed. The dosimetric consequences in computed treatment plans were evaluated based on polychromatic images at 120 kVp. Results: The magnitude of differences was large at lower monochromatic energy levels. The measurements at over 70 keV shows stable HU for polystyrene, acrylic. For CT to ED conversion curve, the shape of the curve at 120 kVp was close to that at 80 keV. 105 keV virtual monochromatic images were more successful than other energies at reducing streak artifacts, which some residual artifacts remained in the corrected image. The dose-calculation variations in radiotherapy treatment planning do not exceed ${\pm}0.7%$. Conclusion: Radiation doses with dual energy CT imaging can be lower than those with single energy CT imaging. The virtual monochromatic images were useful for the revision of CT number, which can be improved for target coverage and electron densities distribution.

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Leptomycin B Increases Radiosensitization by Trichostain A in HeLa Cells (HeLa세포주에서 Leptomicin B에 의한 Trichostain A의 방사선 감작효과의 증가)

  • Kim, In-An;Kim, Jin-Ho;Shin, Jin-Hee;Kim, Il-Han;Kim, Jae-Sung;Wu-Hong, Gyun;Chie, Eui-Kyu;Kim, Yong-Ho;Kim, Bo-Kyung;Hong, Se-Mie;Ha, Sung-Whan;Park, Chan-Il
    • Radiation Oncology Journal
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    • v.23 no.2
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    • pp.116-122
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    • 2005
  • Purpose: Histone deacetylase inhibitors (HDIs) are emerging as potentially useful components of anticancer therapy and their radiosensitizing effects have become evident. Specific HDAS are now available that preferentially inhibit specific HDAC classes; TSA inhibits Class I and II HDACs, and SK7041 inhibits Class I HDACs. Materials and methods: We tested the differential radiosensitization induced by two different classes of HDIs in HeLa cells. We next tested the hypothesis that p53 expression in cancer cells may influence the susceptibility to HDIs by using pharmacologic modification of the p53 status under an isogenic background. Results: It is interesting that p53 expression in the HeLa cells clearly increased the degree of radio-sensitization by TSA compared to that of the class I specific inhibitor SK7041. This suggests that p53 may, in part, be responsible for the mechanistic role for the greater radiosensitization induced by Class I & II inhibitors compared to that of the class I specific inhibitors. Thus, these studies are useful in distinguishing between events mediated solely by the Class I HDACS versus those events involving the other classes of HDACS as well. Conclusion: The anticancer efficacy of targeting Class I and II HDACS, in conjunction with radiation therapy, may be further enhanced by the restoration of p53 expression.

Elementary School in Gwangju Gwangsan Radon gas Density Measurement (광주광역시 광산구 소재 초등학교 라돈가스 농도 계측)

  • Ahn, Byungju;Oh, Jihoon
    • Journal of the Korean Society of Radiology
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    • v.8 no.4
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    • pp.211-216
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    • 2014
  • Radium is rock or soil of crust or uranium of building materials after radioactivity collapse process are created colorless and odorless inert gas that accrue well in sealed space like basement. It inflow to lung circulate respiratory organ and caused lung cancer because of deposition of lung or bronchial tubes. In this study, the air in the elementary school classroom nongdoeul tonkatsu place of measured values were compared using the calculated annual internal radiation exposure. La tonkatsu exposure measured in primary school classroom at least five schools when you close the windows in the average floor 0.56mSv 2 floors ground floor windows when opened 0.384mSv 048mSv 3 floors, 2 floor levels of the same three layers 0.31mSv 0.296mSv the human exposure to radon and radiation on the first floor of 3 floors above ground in a lot of exposure was moderate. When you close the window from the first floor up 0.384mSv 056mSv 3 floors with a minimum annual radiation exposure due to natural radiation in the 16 to 23.3 percent minimum 2.4mSv accounted for. When I opened the window to the maximum annual radiation exposure 2.4mSv 0.296mSv 0.31mSv least a minimum of 12.3 to 12.91% accounted for Results suggest that more than five chodeunghakgyoeun La tonkatsu domestic radon measurements conducted below regulatory requirements and internal exposure has also fall within the normal range. People The less the radiation exposure to the human body because it reduces the impact in the classroom in elementary school vent windows often reduced to the maximum radon concentration in the air, if called tonkatsu be able to reduce radiation exposure for the immune system is weak and elementary will be helpful to experiment more in the future for the school authorities called tonkatsu investigation is done to him if the action to establish a more secure school building facilities is thought would be helpful.

Preparation of $^{99m}Tc-HYNIC-PEG-liposomes$ for Imaging of the Focal Sites of Infection (농양 진단을 위한 $^{99m}Tc-HYNIC-PEG-liposomes$의 제조)

  • Hong, Jun-Pyo;Awh, Ok-Doo;Kim, Hyun-Suk;Lee, Eun-Sook;Lee, Tae-Sup;Choi, Tae-Hyun;Choi, Chang-Woon;Lim, Sang-Moo
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.6
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    • pp.333-343
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    • 2002
  • Purpose: A new linker, hydrazino nicotinamide (HYNIC), was recently introduced for labelling of liposome with $^{99m}Tc$. In this study we synthesized HYNIC derivatized PEG (polyethylene glycol)-liposomes radiolabeled with $^{99m}Tc$. Materials and Methods: In order to synthesize HYNIC-DSPE (distearoyl phosphatidyl ethanolamine) which is a crucial component for $^{99m}Tc$ chelation, first of all succinimidyl 6-BOC-hydrazinopyridine-3-carboxylic acid was synthesized from 6-chloronicotinic acid by three sequential reactions. A DSPE derivative of succinimidyl 6-BOC-hydrazinopyridine-3-carboxylic acid was transformed into HYNIC-DSPE by HCI/dioxane. HYNIC-PEG-liposomes were prepared by hydration of the dried lipid mixture of EPC (egg phosphatidyl choline): PEG-DSPE : HYNIC-DSPE:cholesterol (1.85:0.15:0.07:1, molar ratio). The HYNIC-PEG-liposomes were labeled with $^{99m}Tc$ in the presence of $SnCl_2{\cdot}2H_2O$ (a reducing agent) and tricine (a coligand). To investigate the level of in vivo transchelation of $^{99m}Tc$ in the liposomes, the $^{99m}Tc$-HYNiC-PES-liposomes were incubated with a molar excess of DTPA, cysteine or glutathione solutions at $37^{\circ}C$ for 1 hour. The radiolabeled liposomes were also incubated in the presence of human serum at $37^{\circ}C$ for 24 hours. Results: 6-BOC-hydrazinopyridine-3-carboxylic acid was synthesized with 77.3% overall yield. The HYNIC concentration in the PEG-coated liposome dispersion was 1.08 mM. In condition of considering the measured liposomal size of 106 nm, the phospholipid concentration of $77.5\;{\mu}mol/m{\ell}$ and the liposomal particle number of $5.2{\times}10^{14}$ liposomes/ml, it is corresponded to approximate 1,250 nicotinyl hydrazine group per liposome in HYNIC-PEG-liposome. The removal of free $^{99m}Tc$ was not necessary because the labeling efficiency were above 99%. The radiolabeled liposomes maintained 98%, 96% and 99%, respectively, of radioactivity after incubation with transchelators. The radiolabeled liposomes possessed above 90% of the radioactivity in serum. Conclusion: These results suggest that the HYNIC can be synthesized easily and applied in labelling of PEG-liposomes with $^{99m}Tc$.

Surgical Outcome of Patients with Ischemic Cardiomyopathy Selected by the Results of Myocardial Viability by Preoperative F-18 FDG PET (F-18 FDG 양전자단층촬영을 이용한 생존심근 평가 후 수술한 허혈성 심근병증 환자의 수술 결과)

  • Kim, Jae-Sung;Lee, Dong-Soo;Hong, Suk-Keun;Lee, Young-Tak;Kim, Yu-Kyeong;Kim, Youn-Jung;Moon, Keon-Sik;Won, Tae-Kyoung;Hwang, Hweung-Kon
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.4
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    • pp.276-284
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    • 2000
  • Purpose: We investigated the operative outcome after bypass surgery in patients selected using viability criteria on F-18 FDG PET. Materials and Methods: Rest-24hr delay redistribution imaging of Tl-201 SPECT and F-18 FDG PET were performed in 11 patients. Seven of these 11 patients (6 men, 1 woman) were evaluated to have viable myocardium by F-18 FDG PET. Changes in symptoms and left ventricular ejection fraction (LVEF) after operation were evaluated. Results: In seven of 11 patients, a significant amount of viable myocardium was found on F-18 FDG PET and Tl-201 SPECT. Severity of both chest pain and dyspnea improved markedly in all patients. Mean LVEF improved from 22% to 32%. Conclusion: F-18 FDG PET could be used to select the patients who will benefit from coronary artery bypass surgery.

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Arthroscopic Subscapularis Tendon Repair - Preliminary Report of 8 cases study - (관절경하 견갑하건 봉합술 - 8 례에 대한 예비보고 -)

  • Yun, Ho-Hyun;Moon, Gi-Hyuk;Jang, Jong-Hoon;Yoo, Yon-Sik
    • Journal of the Korean Arthroscopy Society
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    • v.8 no.2
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    • pp.124-131
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    • 2004
  • Purpose: To validate and introduce the technique of the arthroscopic repair for the treatment of the Subscapulris tendon tear. Materials and Methods: From April 2003 to April 2004, Arthroscopic repairs were performed in 8 patient with subscapularis tendon tear. The mean follow-up period was 11months. two cases involved only subscaplaris tendon tear. Four cases were associated small sized posterosuperir. rotator cuff tear and two cases were in large size. The type of subscapularis tendon showed upper portion full-thickness tear in 6 cases, partial-thickness tear localized at articular surface in 1 case, complete tear in 1 case. The results were analyzed by using subjective satisfaction, inferior movenent of superior displaced humeral head, Constant-Murley functional scoring Results: Constant-Murley scoring was improved from 55 point preoperatively to 75 point postoperatively following 11 months. Mean score was 71 point except 2 cases of large superoposterior rotator cuff tear, Most humeral heads were distaracted postoperatively. The subjective result for the 8 shoulders were very satisfying in 5 cases, satisfying in 1 case and dissatisfying in 2 cases. Therefore satisfactory results were noted in 6 cases (75%) of this overall treatment group. Conclusion: The arthroscopic repair for the subscapularis tendon tear is thought to be available method, which could reduce severe complications following the weakness of deltoid muscle and postoperative pain. Especially Partial Subscapularis tear not associated with superoposterior rotator cuff tear including PASTA lesion was the sutable indication of the Arthroscopic repair.

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Arthroscopic Capsular Release in Refractory Adhesive Capsulitis of the Shoulder (견관절 난치성 유착성 관절 낭염에서 관절경 하의 관절낭 유리술)

  • Ko, Sang-Hun;Cho, Sung-Do;Choi, Seoung-Won;Jeong, Ji-Young;Jung, Kwang-Hwan
    • Journal of the Korean Arthroscopy Society
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    • v.8 no.2
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    • pp.109-114
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    • 2004
  • Purpose: To evaluate the clinical results and prove the effectiveness of arthroscopic capsular release in refractory adhesive capsulitis of shoulder. Materials and Methods: We preformed arthroscopic capsular refractory adhesive capsulitis that not responded by stretching execies for above 1 year. 21 cases were followed above 1 year and average follow up 3 years 1 months (1${\sim}$5 years). We checked VAS of pain, ADL of function. UCLA score which were evaluated at preoperation, postoperation 6 months, 1 years and last follow up period, and compared with each other at last follow up. Results: The VAS score improved average preoperative score 8 to average postoperative score1, the ADL score improved average preoperative score 7 to average postoperative score 26, the UCLA score improved average preoperative score 8 to average postoperative score 34. Forward elevation improved average preoperative 75 degrees to average postoperative 175 degrees, external rotatiion at side improved average preoperative 4 degrees to average postoperative 52 degrees, abduction improved average Preoperative 60 degrees to average postoperative 170 degrees, internal rotation at posterior improved preoperative thigh-lumbar 3 spinous process to postoperative 7th thoracic spinous process~9th thoracic spinous process. Conclusion: Arthroscopic capsular release in refractory adhesive capsulitis that non responsive to stretching exercise for above 1 year were effective treatment method.

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