• Journal of Gastric Cancer
• /
• v.6 no.2
• /
• pp.84-90
• /
• 2006

Purpose: The macroscopic findings of tumors are not always identical with the microscopic findings. This study investigated the oncologic implications of macroscopic serosal invasion in advanced gastric cancer to find out how to improve the accuracy for the depth of invasion assessed by the surgeon during an operation. Materials and Methods: The medical records of 789 patients with advanced gastric cancer who underwent a gastrectomy at Kyungpook National University Hospital between 1995 and 1999 were reviewed. The prognoses and the recurrence patterns were analyzed according to macroscopic serosal invasion and microscopic serosal invasion, and the clinico-pathological factors of cT3/ss cancers were compared with those of cT3/se cancers. Results: Difference of survival rates according to macroscopic serosal invasion and microscopic serosal invasion revealed statistically significant. Recurrence rates were similar in patients with macroscopic and microscopic serosal invasion (42.2% and 41.4%, respectively). Peritoneal recurrence rates were also similar (19.8% and 21.9%, respectively). The sensitivity and the specificity of macroscopic assessment of serosal invasion were 70.3% and 77.8%, respectively, On univariate and multivariate analyses, Borrmann type I/II cancers and the absence of distant metastases revealed the risk factors for overestimating of serosal invasion. Conclusion: Macroscopic serosal invasion assessed by a surgeon intraoperatively can be used to give a prognosis and to predict the recurrence pattern precisely, although there is a risk for overestimation when the tumor is a Borrmann type I/II cancer or the tumor has no distant metastases. (J Korean Gastric Cancer Assoc 2006;6:84-90)

• Proceedings of the Korea Water Resources Association Conference
• /
• 2007.05a
• /
• pp.800-804
• /
• 2007

전 세계에서 홍수로 인한 인명손실과 재산적 피해의 기록을 살펴보면 최근 몇 년 동안 꾸준히 증가하고 있다. 이로 인해서 홍수를 방어하기 위한 노력은 증가하게 되었다. 이로 인해 홍수터에서 인구집중과 개발로 인해 홍수방어를 위해서 막대한 투자가 필요하다. 이와 동시에 지속가능하고 효과적인 수자원 관리는 전체적인 접근방법이 요구되며, 사회와 경제발전과 생태계 보호 및 토지이용과 수자원 이용의 적절한 관리와 연결된 개념이 필요하다. 유역은 육지와 수계 사이의 많은 상호작용이 있는 동적인 시스템이다. 이러한 관점에서 유역을 간단한 고정된 지역적인 문제라고 생각하는 것보다 전체로서의 유역 기능을 개선하는데 노력이 필요하고 시도되어야 할 것이다. 통합홍수관리(IFM : Integrated Flood Management)는 홍수의 긍정적인 측면과 부정적인 측면을 고려한 새로운 접근방법이며, 홍수가 자원적 가치를 지닌 것이라고 생각하는 개념이다. 통합홍수관리의 특징은 홍수조절 대책의 적절한 혼합, 대책의 목적 및 형태(구조적 및 비구조적 대책), 단기간 및 장기간 대책 등의 대책들을 통합하는 것이다. 여기에는 전유역의 수문순환 관리, 통합 토지이용 및 수자원 관리, 최적 혼합대책의 적용 및 통합재해관리 적용 등이 있다. 홍수는 자연적인 수문학적 체계의 중요한 요소이며, 주요 수자원이기도 하다. 그리고 빈번한 홍수로 인해 제방을 넘어 홍수터를 점령한다. 이 결과로 상습 홍수범람지역은 점점 더 인구가 밀집되고 있고 홍수에 더 취약하게 된다. 그러므로 금호강유역에 발생한 홍수의 개요, 원인 및 결과에 대해서 살펴보고, 홍수관리대책과 실효성에 대해서 조사 분석하였다. 그리고 홍수가 발생한 후 홍수관리대책과 관리기술의 변화를 통합홍수관리의 개념에서 분석하였다.Jones matrix, which allows a new interpretation in the conversion efficiency of the thin-film optical waveguides.있다는 장점이 있었다. 따라서 소아에서 복막투석도관 수술 시 복강경적 방법을 이용하는 것이 효율적인 복막 투석을 위해 유용하다고 생각된다.상부 방광천자에 비해 민감도 59.5%(25/42), 특이도 86.6%(13/15)였고 위양성률 13.3%(2/15), 위음성률 40.5%(17/42) 로 정확도가 낮았다. 결론 : 소변을 가리지 못하는 영유아에서 요로 감염을 진단하기 위해서는 도뇨관 채뇨에 비해 초음파 감시하 치골상부 방광천자가 정확하고 안전한 채뇨법으로 권장되어야 한다고 생각한다.應裝置) 및 운용(運用)에 별다른 어려움이 없고, 내열성(耐熱性)이 강(强)하므로 쉬운 조건하(條件下)에서 경제적(經濟的)으로 공업적(工業的) 이용(利用)에 유리(有利)하다고 판단(判斷)되어진다.reatinine은 함량이 적었다. 관능검사결과(官能檢査結果) 자가소화(自家消化)시킨 크릴간장은 효소(酵素)처리한 것이나 재래식 콩간장에 비하여 품질 면에서 손색이 없고 저장성(貯藏性)이 좋은 크릴간장을 제조(製造)할 수 있다는 결론을 얻었다.이 있음을 확인할 수 있었다.에 착안하여 침전시 슬러지층과 상등액의 온도차를 측정하여 대사열량의 발생량을 측정하고 슬러지의 활성을 측정할 수 있는 방법을 개발하였다.enin과 Rhaponticin의 작용(作用)에 의(依)한 것이며, 이는 한의학(韓醫學) 방제(方劑) 원리(原理)인 군신좌사(君臣佐使) 이론(理論)에서 군약(君藥)이 주증(主症)에 주(主)로 작용(作用)하는 약물(藥物)이라는 것을 밝혀주는 것이라고 사료(思料)된다.일전 $

• Journal of Gastric Cancer
• /
• v.5 no.1
• /
• pp.34-39
• /
• 2005

Purpose: KLF6, a member of the KLF family, is a ubiquitous zinc finger tumor suppressor protein that is mutated in several human cancers. Our aim was to determine whether the expression pattern of KLF6 might be associated with gastric cancer development and, if so, to determine to which pathologic parameter it is linked. Materials and Methods: For the construction of the gastric cancer tissue microarray, 85 paraffin-embedded tissues containing gastric cancer areas were cored 3 times and transferred to the recipient master block. The expression pattern of KLF6 was examined on tissue microarray slides by using immunohistochemistry and was compared with pathologic parameters, including histologic type, depth of invasion, lymph node metastasis, and peritoneal dissemination. Results: The KLF6 protein was expressed on superficial and foveolar epithelial cells in the gastric mucosa. We found loss of KLF6 expression in 28 ($32.9\%$) of the 85 gastric cancer tissues. There was a significant correlation between loss of KLF6 expression and lymph-node metastasis. However, other pathologic parameters, such as histologic type, depth of invasion, and peritoneal dissemination, were not statistically associated with loss of KLF6 expression. Conclusion: Our findings suggest that loss of KLF6 expression may contribute to abnormal regulation of gastrointestinal epithelial cell growth and differentiation and to the development and/or progression of Korean gastric cancer.

• Journal of Gastric Cancer
• /
• v.6 no.1
• /
• pp.25-30
• /
• 2006

Purpose: The EphB2 receptor, a member of the receptor tyrosine kinase family, is a target gene of the Wnt signaling pathway and may achieve a tumor suppressor function through regulation of cell growth and migration. Our aim was to determine whether an altered expression of EphB2 might be associated with gastric cancer development and, if so, to determine to which pathologic parameter it is linked. Materials and Methods: For the construction of the gastric cancer tissue microarray, 83 paraffin-embedded tissues containing gastric cancer areas were cored 3 times and transferred to the recipient master block. The expression patterns of EphB2 were examined on tissue microarray slides by using immunohistochemistry and were compared using pathologic parameters, including histological type, depth of invasion, lymph node metastatsis, and peritoneal dissemination. Results: The EphB2 protein was expressed in the normal gastric mucosal epithelium, especially in the bottom of the mucosa. We found loss of EphB2 expression in 30 (36.1%) of the 83 gastric cancer tissues. Statistically, loss of EphB2 expression was more common in gastric cancer with lymph-node metastasis. There was no significant correlation between EphB2 expression and depth of invasion, histologic type, or peritoneal dissemination. Conclusion: Our findings suggest that loss of EphB2 expression may represent a critical step in gastric carcinogenesis.

• Radiation Oncology Journal
• /
• v.16 no.1
• /
• pp.17-25
• /
• 1998

Purpose : Although local recurrence rates of stomach cancer after radiocal surgery have been reported in the range of $30-70\%$, the role of postoperative adjuvant therapy has not been established. We report the result of radiotherapy in resected stomach cancer with positive surgical margin to elucidate the role of postoperative radiotherapy. Materials and Methods : From June 1991 to August 1996, twenty five patients with positive surgical margins after radical gastrectomy were treated with postoperative radiotherapy and chemotherapy. Median dose of radiation was 55.8Gy and the range was 44.6-59.4Gy. Second cycle of chemotherapy was delivered concurrently with radiation and total number of six cycles were delivered. Twenty three had adenocarcinoma and the other two had leiornyosarcoma. The numbers of patients with stage I B, II, III A, III B, and IV were 1, 2, 11, 10 and 1 respectively. Positive margins at distal end of the stomach were in 17 patients and proximal in 5. The other three patients had positive margin at the sites of adjacent organ invasion Minimum and median follow-up periods were 12 months and 18 months, respectively, Results : Twenty-four of 25 patients received prescribed radiation dose and RTOG grade 3 toxicity of UGI tract was observed in 3, all of which were weight loss more than $15\%$ of their pretreatment weight. But hematemesis. melena, intestinal obstruction or grade 4 toxicity were not found. Locoregional failure within the radiation field was observed in 7 patients, and distant metastasis in 10 patients. Sites of locoregional recurrences involve anastomosis/remnant stomach in 3, tumor bed/duodenal stump in 3, regional lymph node in 1 patient Peritoneal seeding occurred in 6, liver metastases months and median disease free survival time was 26 months. Stages andradiation dose were not significant prognostic factors for locoregional in 2, and distant nodes in 2 patients. Four year disease specificsurvival rate was $40\%$ and disease free survival was $48\%$. Median survival was 35 failures. Conculsion : Although all patients in this study had positive surgical margins, locoregional failure rate was $28\%$, and 4 year disease specific survival rate was $40\%$. Considering small number of patients and relatively short follow-up period, it is not certain that postoperative radiotherapy lowered locoregional recurrences. but we could find a Possibility of the role of postoperative radiotherapy in Patients with high risk factors.

• Journal of Gastric Cancer
• /
• v.6 no.3
• /
• pp.125-131
• /
• 2006

Purpose: Free cancer cells exfoliated from cancer-invaded serosa contribute to peritoneal dissemination, the most frequent pattern of recurrence in patients with gastric cancer. To detect free cancer cells, CEA and CA19-9 were introduced as the markers of gastric cancer, and many methods, such as cytology, immunoassay, and reverse transcription polymerase chain reaction (RT-PCR), exist for detecting them. The aim of this study is to define the clinical significance of using immunoassay to measure the levels of CEA and CA19-9 in the peritoneal washings in patients with gastric cancer. Materials and Methods: The peritoneal washing fluids were obtained from 130 patients with gastric cancer who received a curative gastrectomy, palliative gastrectomy or open and closure. The pCEA and pCA19-9 levels were measured by using immunoassay and cytology. The results were compared with the clinicopathological data. Results: The pCEA and pCA19-9 levels were correlated with tumor invasion, lymph-node metastasis, and stage (P<0.05). Conclusion: A correlation was found between elevated pCEA and pCA19-9 levels measured by immunoassay and the TNM stage. Therefore, a combined pCEA and pCA19-9 assay could be a sensitive detector of peritoneal dissemination, as well as a predictor of postoperative prognosis. pCEA and pCA19-9 may also determine the adjuvant management strategy.

• Clinical and Experimental Pediatrics
• /
• v.48 no.4
• /
• pp.433-437
• /
• 2005

Bezoars are concretions commonly found in the stomach and small bowel, and four types of bezoars have been described based on their composition : trichobezoar, phytobezoar, lactorbezoar, and miscellaneous. Bezoars most often develop after gastric operations that alter the motility, emptying, and grinding of food in the stomach. Trichobezoars are most common in female children with normal gastrointestinal function and are usually associated with pica, mental retardation, and psychiatric disorders. Although uncommon, bezoars are a well-recognized cause of chronic abdominal complaints which, when undiagnosed, can result in serious complications including gastric ulceration, bleeding, perforation, intussusception and small bowel obstruction. Mortality rates of up to 30 percent have been reported in adults. Trichotillomania is behaviors surrounding hair-pulling, including stroking and playing with hair before pulling, or biting and swallowing the hair after it has been pulled(trichophagia). The most notorious of the medical sequelae of trichotillomania is the trichobezoar. We experienced a case of trichobezoar in an 11-year-old girl who frequently swallowed her hairs from age 4 years up to age 7 years, resulting in intermittent abdominal pain, nausea, and vomiting.

• Childhood Kidney Diseases
• /
• v.6 no.1
• /
• pp.120-122
• /
• 2002

A 9-year-old boy of B blood group with end-stage renal disease due to IgA nephropathy received group O kidney transplantation from his father On day 9, he developed intravascular hemolysis, and anti-B autoantibody formation was confirmed. We diagnosed as immune hemolytic anemia due to passenger lymphocyte from donor, and cyclosporine withdrawl was done. Anemia resolved spontaneously, but on day 18, graft dysfunction developed, and graft biopsy revealed acute allograft rejection. Although hemolysis due to autoantibody is very rare and often mild, and the role of hemoglobinuria on acute rejection in this case is not certain, we recommend consideration of aggressive management on severe hemolysis after minor mismatched kidney transplantation. (J Korean Soc Pediatr Nephrol 2002 ; 6 : 120-2)

• Journal of Chest Surgery
• /
• v.30 no.12
• /
• pp.1251-1253
• /
• 1997

Gastrointestinal complications, especially duodenal complication after cardiopulmonary bypass are rare, but often fatal. We experienced 1 case of duodenal ulcer bleeding and 2 cases of duodenal ulcer perforation developing after cardiopulmonary bypass from August 1994 to April 1996. In the case of duodenal ulcer bleeding, palpitation, dizziness, tachycardia and melena were the clues leading to diagnosis, and in the cases of perforation, abdominal distension with pain, tachycardia, hypotension, oliguria were the clues. Duodenal perforations were diagnosed by abdominal paracentesis. The patient with duodenal bleeding was treated by H-2 receptor antagonist, antacids and transfusion. And emergency laparotomy was required for the patients with duodenal perforation. In addition to ulcer prophylaxis including H-2 receptor antagonist and antacids, a high index of suspicion and timely surgery are necessary for early diagnosis and appropriate treatment of duodenal complication developing af er cardiopulmonary bypass.

• Journal of Veterinary Clinics
• /
• v.33 no.1
• /
• pp.39-42
• /
• 2016

A 10 months old, male Poongsan dog was referred with a history of right forelimb lameness due to hit by a car a few hours before presentation. On the physical examination, the dog showed pale mucous membrane, respiration distress, and skin abrasions. The main laboratory finding was leukocytosis, while hematocrit was normal. Abdominal radiography revealed the loss of abdominal serosal detail, which was diagnosed as peritoneal hemorrhage on ultrasonography (US) and aspiration. On computed tomography (CT), hepatic and splenic injuries were seen characterized by the discontinuity of the capsule with irregular margin and lower density lesions than parenchyma. No contrast enhancing area were shown in the laceration lesion. The accessory spleen was incidentally found by US and CT. In this case, acute intra-abdominal hemorrhage from splenic and hepatic laceration was diagnosed using CT.