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Laparoscopic Assisted Total Gastrectomy (LATG) with Extracorporeal Anastomosis and using Circular Stapler for Middle or Upper Early Gastric Carcinoma: Reviews of Single Surgeon's Experience of 48 Consecutive Patients (원형 자동문합기를 이용한 체외문합을 시행한 복강경 보조 위전절제술: 한 술자에 의한 연속적인 48명 환자의 수술성적분석)

  • Cheong, Oh;Kim, Byung-Sik;Yook, Jeong-Hwan;Oh, Sung-Tae;Lim, Jeong-Taek;Kim, Kab-Jung;Choi, Ji-Eun;Park, Gun-Chun
    • Journal of Gastric Cancer
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    • v.8 no.1
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    • pp.27-34
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    • 2008
  • Purpose: Many recent studies have reported on the feasibility and usefulness of laparoscopy assisted distal gastrectomy (LADG) for treating early gastric cancer. On the other hand, there has been few reports about laparoscopy assisted total gastrectomy (LATG) because upper located gastric cancer is relatively rare and the surgical technique is more difficult than that for LADG, We now present our procedure and results of performing LATG for the gastric cancer located in the upper or middle portion of the stomach. Materials and Methods: From Jan 2005 to Sep 2007, 96 patients underwent LATG by four surgeons at the Asan Medical Center, Seoul, Korea. Among them, 48 consecutive patients who were operated on by asingle surgeon were analyzed with respect to the clinicopathological features, the surgical results and the postoperative courses with using the prospectively collected laparoscopy surgery data. Results: There was no conversion to open surgery during LATG. For all the reconstructions, Roux-en Y esophago-jejunostomy and D1+beta lymphadenectomy were the standard procedures. The mean operation time was $212{\pm}67$ minutes. The mean total number of retrieved lymph nodes was $28.9{\pm}10.54$ (range: $12{\sim}64$) and all the patients had a clear proximal resection margin in their final pathologic reports. The mean time to passing gas, first oral feeding and discharge from the hospital was 2.98, 3.67 and 7.08 days, respectively. There were 5 surgical complications and 2 non-surgical complications for 5 (10.4%) patients, and there was no mortality. None of the patients needed operation because of complications and they recovered with conservative treatments. The mean operation time remained constant after 20 cases and so a learning curve was present. The morbidity rate was not different between the two periods, but the postoperative course was significantly better after the learning curve. Analysis of the factors contributing to the postoperative morbidity, with using logistic regression analysis, showed that the 8MI is the only contributing factor forpostoperative complications (P=0.029, HR=2.513, 95% CI=1.097-5.755). Conclusions: LATG with regional lymph node dissection for upper and middle early gastric cancer is considered to be a safe, feasible method that showed an excellent postoperative course and acceptable morbidity. BMI should be considered in the patient selection at the beginning period because of the impact of the BMI on the postoperative morbidity.

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Aquaporin in bleomycin induced lung injury (급성 폐손상 동물모델에서 aquaporin 수분통로의 발현)

  • Jang, An-Soo;Park, Jong-Sook;Lee, June-Hyuk;Park, Sung-Woo;Kim, Do-Jin;Uh, Soo-Taek;Kim, Yong-Hoon;Park, Choon-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.3
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    • pp.330-336
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    • 2006
  • Background : Aquaporins (AQPs) may play a role in the pathogenesis of pulmonary inflammation and edema. This study investigated the role ofAQPs in acute lung injury following bleomycin inhalation in rats. Methods : Sprague-Dawley rats were treated via inhalation with 10 U/kg bleomycin hydrochloride dissolved in 5 ml of normal saline. The control rats were treated with 5 ml normal saline. The animals (n = 6-8 rats per group) were sacrificed at 4, 7, and 14 d. The changes in AQP1, AQP4, and AQP5 expression levels over time were analyzed by Western blotting. The nitrate and nitrite concentrations in the bronchoalveolar lavage fluid (BALF) were measured using a modified Griess reaction. ELISA was used to check cytokines. Results : The respiration rates were significantly higher 4 and 7 days after the bleomycin treatment compared with those of the control rats. The tidal volume was lower in rats at 4 days after the bleomycin treatment, and the wet/dry weights of the lung were significantly higher than those of the control group. The nitrite and nitrate concentrations in the BALF from the rats at 4 days after exposure to bleomycin were greater than those from the saline-treated rats. Immunoblotting studies demonstrated that the AQP1 and AQP4 expression levels were lower in the rats at 4 days. However, the AQP4 expression level was higher at 7 days. The AQP5 expression level increased at 4, 7 and 14 days after the bleomycin treatment. Conclusion : This study demonstrates that AQPs are expressed differently in bleomycin-induced pulmonary edema.

Study of Antidotes on the Nephrotoxicity of Ochratoxin A (Ochratoxin A의 신장독성감소 방법에 대한 연구)

  • 서경원;김준규;김태완;정세영;김효정
    • Journal of Food Hygiene and Safety
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    • v.13 no.2
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    • pp.121-128
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    • 1998
  • Ochratoxin A (OA) is a mycotoxin produced by Aspergillus ochraceus as well as other molds. It is a natural contaminant of mouldy food and feed. OA has a number of toxic effects, the most prominant being nephrotoxicity. Futhermore, OA is immunosuppressive, genotoxic, teratogenic and carcinogenic. OA inhibits protein synthesis by competition with phenylalanine in the phenylalanine-tRNA aminoacylation reaction. Recently, lipid peroxidation induced by OA has been reported, indicating that the lesion induced by this mycotoxin could be also related to oxidative pathway. Since it seems impossible to avoid contamination of foodstuffs by toxigenic fungi, detoxification and detoxication of OA are needed. In this study we investigated the protective effects of aspartame (Asp), phenylalanine (Phe), polyphenol 70S (PP) and aloe extract (AE) on the nephrotoxicity induced by subacute exposure to the OA. Asp and Phe are structural analogues of OA. PP, an ingredient of Green Tea and AE have been known as antioxidant and radical scavenger. Phe (40 mg/kg, i.p.) and Asp (25 mg/kg, p.o.) were administered to Sprague-Dawley rats simultaneously with OA (2.0 mg/kg, p.o.) for 2 weeks. PP (200 mg/kg, p.o.) and AE (50 mg/kg, i.v.) were pretreated before administration of OA, for 2 weeks and 3 days, respectively. Using enzymuria, BUN level, creatinemia and histophathologic examination as indices of renal damage, we observed that all of four compounds prevented the nephrotoxic effects induced by OA. It seems that structural analogues of OA such as Asp and Phe have better protective effect on the nephrotoxicity of OA than antioxidants. These results indicate that 1) formation of free radical and lipid peroxidation are likely to be involved in the nephrotoxicity of OA in vivo, 2) Asp, PP and AE might be used for prevention of renal lesions in cases of ochratoxicosis.

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Studies on the Quality and Utilization of Pumpkin Silages (호박 Silage의 품질(品質) 및 이용성(利用性)에 관(關)한 연구(硏究))

  • Kim, Y.K.;Kim, S.K.
    • Korean Journal of Agricultural Science
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    • v.3 no.1
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    • pp.77-84
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    • 1976
  • The preservation efficiency, quality and utilization of silage from 3 species of pumpkins (Mammoth pumpkin, Queensland blue pumpkin, Korean pumpkin) without and with 10, and 20% wheat bran additive were studied in this experiment. Silages were analysised and tested the chemical composition, pH and quality of silages between at 40-60 days and egg performance were carried out with mammoth pumpkin silage without additive. The results were summaried as follows. 1. The losses of all silage ware lower and similar as about 15% at 6 monthes following after silage-making but all raw pumpkins were spoilaged during the winter storaging. 2. The moisture content of silages were higher as about 97% in mammoth pumpkin silage, 94% in Queensland pumpkin silage and 91% in Korean pumpkin silage without additive and all nutrient content of silage without and with additive were depended on its content of raw silage material of pumpkins and wheat bran. The contents of moisture and N-free extract were slightly decrease but not significantly difference during the silaging and other contents were not so much changed. 3. Good quality of silage were made from all pumpkins with and without additive. Organic acid contents were 2.09-2.93% of lactic acid, 0.68-1.71% of acetic acid and 0% of butyric acid and it was pH 3.8-4.0 in silages. 4. Feed intakes, egg production and quality of egg were showed good result in 5.0 and 7.5% silage feeding group as D.M. base for egg performance. (P<0.01) 5. It was concluded that good quality of silage were made from pumpkins with and without wheat bran additive and it was suggested that poor quality feedstuff may be improved it feeding value by extended palatability with pumpkin additive silage.

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The Use of Normal Tissue Complication Probability to Predict Radiation Hepatitis (간암의 정상조직손상확률을 이용한 방사선간염의 발생여부 예측가능성에 관한 연구)

  • Keum Ki Chang;Seong Jinsil;Suh Chang Ok;Lee Sang-wook;Chung Eun Ji;Shin Hyun Soo;Kim Gwi Eon
    • Radiation Oncology Journal
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    • v.18 no.4
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    • pp.277-282
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    • 2000
  • Purpose : Though It has been known that the to tolerance of the liver to external beam irradiation depends on the irradiated volume and dose, few data exist which Quantify this dependence. However, recently, with the development of three dimensional (3-D) treatment planning, have the tools to Quantify the relationships between dose, volume, and normal tissue complications become available. The objective of this study is to investigate the relationships between normal tissue complication probabili쇼 (WCP) and the risk of radiation hepatitis for patients who received variant dose partial liver irradiation. Materials and Methods : From March 1992 to December 1994, 10 patients with hepatoma and 10 patients with bile duct cancer were included in this study. Eighteen patients had normal hepatic function, but 2 patients (prothrombin time 73$\%$, 68$\%$) had mild liver cirrhosis before irradiation. Radiation therapy was delivered with 10MV linear accelerator, 180$\~$200 cGy fraction per day. The total dose ranged from 3,960 cGy to 6,000 cGy (median dose 5,040 cGy). The normal tissue complication probability was calculated by using Lyman's model. Radiation hepatitis was defined as the development of anicteric elevation of alkaline phosphatase of at least two fold and non-malignant ascites in the absence of documented progressive. Results: The calculated NTCP ranged from 0.001 to 0.840 (median 0.05). Three of the 20 patients developed radiation hepatitis. The NTCP of the patients with radiation hepatitis were 0.390, 0.528, 0.844(median : 0.58$\pm$0.23), but that of the patients without radiation hepatitis ranged fro 0.001 to 0.308 (median .0.09$\pm$0.09). When the NTCP was calculated by using the volume factor of 0.32, a radiation hepatitis was observed only in patients with the NTCP value more than 0.39. By contrast, clinical results of evolving radiation hepatitis were not well correlated with NTCP value calculated when the volume factor of 0.69 was applied. On the basis of these observations, the volume factor of 0.32 was more correlated to predict a radiation hepatitis. Conclusion : The risk of radiation hepatitis was increased above the cut-off value. Therefore the NTCP seems to be used for predicting the radiation hepatitis.

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Acid Tolerance of the Acid-Resistant Mutant of Leuconostoc paramesenteroides Improved for Kimchi Starter. (김치 Starter용으로 개량된 Leuconostoc paramesenteroides의 내산성 변이주가 갖는 내산성 특성)

  • 김영찬;정은영;김은해;정대현;최태부;권태종;강상모
    • Microbiology and Biotechnology Letters
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    • v.26 no.4
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    • pp.275-282
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    • 1998
  • To investigate the increased acid tolerance of a acid-resistant mutant Leuconostoc paramesenteroides P-100 improved as a kimchi starter, proton permeability, ATPase acitivity, glycolysis activity, $Mg^2$sup +/ releasement, and membrane fatty acid composition were studied and comprised with its wild type Leuconostoc paramesenteroides Pw. In the proton permeability experiment, the maximum values of the average half time (t$\_$1/2/) of pH equilibration through the cell membrane of the Pw and the P-100 were about 6.4 min and 7.8 min in 150 mM KCI solution, respectively. In the 3% NaCl solution, the t$\_$1/2/ values of the Pw and the P-100 were 5.5 min and 6.9 min, respectively. The values and pHs of maximal specific activities of ATPase originated from the Pw and the P-100 were 0.5 unit/mg protein and 0.78 unit/mg protein at pH 6.0, respectively. The result of pH dependence of glycolysis showed that the P-100 had higher activities than that of Pw except at pH 7.0. The releases of magnesium from the Pw and the P-100 were observed about 54.5% and 23.2% at pH 4.0 after 2 hours, respectively. The results of comparison of membrane fatty acid composition of the Pw with the P-100 showed that C$\_$8:0/, C$\_$9:0/, C$\_$10:0/, C$\_$11:0/, C$\_$18:0/, and C$\_$19:0,cyclo/ were major different fatty acids between two strains and the content of C$\_$18:1/, and C$\_$19:0,cyclo/ were 2.8%, N.D (not detected) in the Pw and 0.4%, 2.3% in the P-100. These results indicated that acid tolerance of the P-100 was significantly improved in comparison with its wild type Pw.

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Changes of Root Yield and Paeoniflorin Content by Cultivated Years in Paeonia lactiflora PALLS (작약(芍藥) 재배년수(栽培年數)에 따른 근수량(根收量) 및 Paeoniflorin함량변화(含量變化))

  • Kim, Ki-Jae;You, Oh-Jong;Jeong, Yeun-Seon;Park, So-Deuk;Shin, Jong-Hee;Hwang, Hyung-Baek;Choi, Boo-Sull
    • Korean Journal of Medicinal Crop Science
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    • v.4 no.1
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    • pp.68-73
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    • 1996
  • Stem length, main root length and main root diameter showed rapid increasement in two-years-old and three-years-old peony. And there after, the increasement was almost finished. Occurrence of disease was increasing every cultivated year, especially the development of leaf spot was most serious. In propagation by root dividing method, the radix yield (kg/10a) was increasing every cultivated year. However, the difference of radix yield at four and five-years-old peony were not significant. The radix yield of four-years-old peony was higher 26% than three-years-old one. As cultivated year goes by, content of paeoniflorin was increasing then the content was highest at four-years-old peony (4.06%). In 1995, the content, had no certain tendency, was highest at three-years-old peony (3.14%). At hot air drying, browing of peony radix was increasing every cultivated year. If we consider radix yield and color, three-years-old peony was proper object of harvesting.

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Synthesis of Ultra High Refractive Index Monomer for Plastic Optical Lens and Its Ophthalmic Lens Preparation (플라스틱 안경렌즈용 초고굴절 모노머 합성 및 이를 이용한 안경렌즈 제조)

  • Jang, Dong Gyu;Kim, Jong Hyo;Lee, Soo Min;Roh, Soo Gyun
    • Journal of Korean Ophthalmic Optics Society
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    • v.13 no.3
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    • pp.1-6
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    • 2008
  • Purpose: Plastic optical monomer materials having ultra high refractive index have an income of the whole quantity from advanced nations to domestic companies which are related to plastic optical lens. It is necessary to develop novel plastic optical lens materials in order to overcome a FTA provision and revitalize a stagnating optical lens industry in the interior optical lens industries. The new plastic optical lens materials against the substitution effect of income should be gradually demanded. This work will be synthesized novel super high refractive monomer resin materials of urethane lens series and studied the properties of optical lens using it. Methods: ETS-4 (2-(2-mercaptoethylthio)-3-{2-[3-mercapto-2-(2-mercaptoethylthio)propyl thio]ethylthio}propane -1-thiol), which is optical lens monomer resin having super high refractive index, was synthesized and identified its structure and property by elemental analysis, EI-MS, TGA, FT-IR spectroscopy, $^1H$ and $^{13}C$ NMR spectroscopies. After mixing evenly from mixed monomer resin and diisocyanate series, it was casting in glass mold. After thermal curing, the obtained optical lenses were measured and compared with the refractive index and Abbe number for studies of their optical properties. Results: We have synthesized the novel ultra high refractive index monomer resin, ETS-4, and have identified its structure and property by elemental analysis, EI-MS, TGA, FT-IR spectroscopy, $^1H$ and $^{13}C$ NMR spectroscopies. The existence of three isomers for EST-4 was identified by $^{13}C$ NMR spectroscopy. The refractive index ($N_d$ at $25^{\circ}C$) of monomer resin in liquid state obtained from the Abbe refractometer was 1.647. The refractive indexes of raw plastic optical lenses prepared from the mixed ETS-4 monomer and diisocyanate series were in the range of 1.656~1.680. Conclusions: Novel super high refractive index plastic optical lens monomer was synthesized and analysed, the optical lenses prepared using it were colorless transparency and excellent properties. It is of utility for the industrialization.

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On Listening, Reflection and Meditation in Vedānta (베단따의 '듣기·숙고하기·명상하기'(문·사·수)에 관하여)

  • Park, Hyo-yeop
    • Journal of Korean Philosophical Society
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    • v.116
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    • pp.155-180
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    • 2010
  • The three means of listening, reflection and meditation (${\acute{s}}raava{\d{n}}a$, manana and $nididhy{\bar{a}}sana$) which are central devices of practice in $Ved{\bar{a}}nta$ philosophy should be understood not as a continuative step but as a methodological extension on condition of having one and the same purpose. In other words, the three means should be interpreted in a listening-oriented manner, in which the process has to be methodologically extended to reflection and meditation only when the direct knowledge on the reality is not gained in listening. This kind of interpretation can be more justified by displaying significant characteristics of Indian philosophy implied in the three means. It can be easily said that $Ved{\bar{a}}nta$ belonging to the liberation-centric tradition is a project of 'regaining essential self' through which the self becomes essential self by knowing that self. In this case the listening-oriented interpretation coincides with the basic teachings of $Ved{\bar{a}}nta$, since listening alone can be a sufficient means for obtaining knowledge of the original self. Further, as the project of 'regaining essential self' is carried out by the three means, these can be called a sort of 'event' that is carried out according to the scenario of $Ved{\bar{a}}ntic$ metaphysics. In this case listening is a course of comprehending the scenario of event participated by oneself, and that participant can accomplish the project by way of listening the scenario alone judged as somewhat more effective for liberation. However, in the later $Ved{\bar{a}}nta$ there arises a meditation-oriented interpretation of which three means are regarded not as a methodological extension but as a continuative step, because of the emphasis on meditation under the lasting influence of other philosophical systems. This is a result of epistemic desire that tries to convert what is heard to what is specially perceived or what is given to what is accepted. It may be said that this interpretation emphasizing the phased transition from the indirect to the direct of knowledge is an attempt to rationalize the repetitive delay of event as the actual failure of project. Furthermore, an assertion of the later $Ved{\bar{a}}nta$ which refers the fourth means called $sam{\bar{a}}dhi$ is based on the logic that the self-realization is possible apart from and outside the text, and accordingly it is incompatible with an assertion of the early $Ved{\bar{a}}nta$ that the self-realization is a reproduction as it is of the scenario guided by the absolute text. After all, the standard interpretation on the three means in $Ved{\bar{a}}nta$ have to be the listening-oriented, but not be the meditation-oriented or the $sam{\bar{a}}dhi$-oriented.

Performance assessment of an urban stormwater infiltration trench considering facility maintenance (침투도랑 유지관리를 통한 도시 강우유출수 처리 성능 평가)

  • Reyes, N.J. D.G.;Geronimo, F.K.F.;Choi, H.S.;Kim, L.H.
    • Journal of Wetlands Research
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    • v.20 no.4
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    • pp.424-431
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    • 2018
  • Stormwater runoff containing considerable amounts of pollutants such as particulates, organics, nutrients, and heavy metals contaminate natural bodies of water. At present, best management practices (BMP) intended to reduce the volume and treat pollutants from stormwater runoff were devised to serve as cost-effective measures of stormwater management. However, improper design and lack of proper maintenance can lead to degradation of the facility, making it unable to perform its intended function. This study evaluated an infiltration trench (IT) that went through a series of maintenance operations. 41 monitored rainfall events from 2009 to 2016 were used to evaluate the pollutant removal capabilities of the IT. Assessment of the water quality and hydrological data revealed that the inflow volume was the most relative factor affecting the unit pollutant loads (UPL) entering the facility. Seasonal variations also affected the pollutant removal capabilities of the IT. During the summer season, the increased rainfall depths and runoff volumes diminished the pollutant removal efficiency (RE) of the facility due to increased volumes that washed off larger pollutant loads and caused the IT to overflow. Moreover, the system also exhibited reduced pollutant RE for the winter season due to frozen media layers and chemical-related mechanisms impacted by the low winter temperature. Maintenance operations also posed considerable effects of the performance of the IT. During the first two years of operation, the IT exhibited a decrease in pollutant RE due to aging and lack of proper maintenance. However, some events also showed reduced pollutant RE succeeding the maintenance as a result of disturbed sediments that were not removed from the geotextile. Ultimately, the presented effects of maintenance operations in relation to the pollutant RE of the system may lead to the optimization of maintenance schedules and procedures for BMP of same structure.