• Journal of Gastric Cancer
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• v.9 no.4
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• pp.231-237
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• 2009

Purpose: The aim of this study was to evaluate the significance of palliative gastrojejunostomy for treating patients with unresectable stage IV gastric cancer, and as compared with laparotomy for treating patients with incurable gastric cancer. Materials and Methods: We retrospectively studied 167 patients who could not undergo resection without obstruction at Korea University Hospital from 1984 to 2007. They were classified into two groups, one that underwent palliative gastrojejnostomy (the bypass group, n=62) and one that underwent explo-laparotomy (the O&C group, n=105), and the clinical data and operative outcomes were compared according to the groups. Results: For the clinical characteristics, there were no differences of age, gender and liver metastasis between the bypass group and the explo-laparotomy group, but there was a significant different for the presence of peritoneal metastasis (P=0.001). There was no difference between two groups for the postoperative mortality and morbidity. For the postoperative outcomes, the duration of the hospital stay (29.25 vs 16.67) and the frequency of re-admission were not different, but the median overall survival (4.3 months vs. 3.4 months, respectively) was significantly different. By multivariate analysis, the presence of peritoneal metastasis was identified as the independent prognostic factor for incurable gastric cancer. Conclusion: A prophylactic bypass procedure is not effective for improving the quality of life and prolonging the life expectancy of unresectable stage IV gastric cancer patients without obstruction.

• Journal of Gastric Cancer
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• v.6 no.2
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• pp.97-102
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• 2006

Purpose: The prognosis for patients with a Borrmann type IV gastric cancer is extremely poor despite an aggressive surgical approach. We evaluated the clinicopathological features for Borrmann type IV cancers to find treatment strategy. Materials and Methods: The 1098 patients with advanced gastric cancer who underwent surgical resection between 1990 and 2001 were analyzed. These patients were divided into two groups: 81 patients with a Borrmann type IV carcinoma, and 1017 patients with all other types of gastric carcinomas. Results: Patients with a Borrmann type IV carcinoma were younger than those with other types, and female was prevalent (p=0.000). Of the patients with a Borrmann type IV gastric carcinoma, 68 patients (84%) were classified as stage III or IV at the initial diagnosis. The histologic type was commonly undifferentiated and serosal infiltration; nodal involvement and lymphatic invasion were more frequent in patients with a Borrmann type IV than in those with other types of cancer. Multivariate analysis confirmed that the extent of lymph node metastasis was a negative prognostic factor for Borrmann type IV gastric carcinomas. The curability for a Borrmann type IV carcinoma was only 53.1%, and peritoneal dissemination rate was 25.9%. The predominant pattern of recurrence for a Borrmann type IV gastric carcinoma was peritoneal dissemination, and it was significantly different with other types (93.1% vs 55.8%, P<0.05). The 5-year survival rate of patients with a Borrmann type IV gastric carcinoma was significantly lower than those of patients with other types of cancer, even though a curative resection had been accomplished (26% vs 63%, p<0.005). The 5-year survival rates of patients with a Borrmann type IV carcinoma following a curative resection were 44.9%, 24%, and 0% for stages II, III and IV, respectively (p<0.05). Conclusion: Because the prognosis for patients of a Borrmann type IV gastric cancer is extremely poor despite a curative resection, preoperative and/or intraperitoneal chemotherapy should be considered. And diagnostic laparoscopy and peritoneal cytology may be used to play an important role in accurate staging workup. (J Korean Gastric Cancer Assoc 2006;6:97-102)

• Journal of Korean Biological Nursing Science
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• v.6 no.2
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• pp.43-55
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• 2004

Purpose : This study was conducted to identify the peritonitis occurence of CAPD, by which a basis for efficient patient management could be provided. Method: Data were collected by questionnaires and hospital record from 55 people who underwent or were going through CAPD from January 1998 to April 2004 in a university subsidiary hospital kidney department. Result: 1) There were many elderly people of 61 years or above taking up 50.9%, 75% had low levels of education with middle school graduation or less, and the cases where separate individual rooms enabling the exchange of CAPD were not possessed was shown to be 61.8%. 2) With the management feature of CAPD, those who bathed once or less per 7 days made up 60.0%, and 60% washed their hands well before exchanging solutions which meant that 40% did not wash well or just washed moderately, and in terms of CAPD education, the proportion of those receiving education both before and after dialysis was 29.1%. also, with nutrition conditions, cases where the level of serum albumin was lower than 3.0 made up 38.2%, and those who were conducting self CAPD management was 65.5%, and cases where the management was done by the spouse or family members was revealed to be 34.5%. 3) There were Peritonitis occurrences in 40% of cases, and the number of Peritonitis occurrences within the period was 36, with an occurrence rate of $0.65{\pm}0.99$. Also, 66.7% of the causing bacteria were no growth, Gram positive bacteria made up 27.8%, and Gram negative bacteria consisted of 5.5%. 4) No significant difference was found peritionitis occurrence according to general and management characteristics. Lower peritionitis occurrence were shown with those who had spouses or family members conducting CAPD management as opposed to self-managing patients(p=0.037). Conclusion: Elderly patients there needs to be the participation of family or other support resources rather than subjecting them to self-management of solution exchange and entry/exit. Also, The high occurrence rate from Gram positive bacteria is shown so the importance of CAPD management education including bathing and hand washing needs to be emphasized.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.10
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• pp.4962-4969
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• 2013

The purpose of this experiment is to evaluate of optimized FS techniques for T2 weighted abdominal MRI compared of TSE-SPIR fat suppression and GE-PROSET fat suppression. All MR examinations were performed on a 1.5 T(Philips, Medical System, Achieva) scanner using 16 channel mult-coils. All images were performed in the axial plane using TSE-SPIR and GE-PROSET. The mean SNRs of the retroperitoneal and mesenteric fat for TSE-SPIR and GE-PROSET were 31.50, 4.15 and 32.39, 7.03. The mean CNRs of the bowel and retroperitoneal, mesenteric fat for TSE-SPIR and GE-PROSET were 52.69, 74.54 and 26.12, 68.78). The delineation of bowel wall margins with TSE-SPIR(2.4) and GE-PROSET(1.8) were significantly improved using TSE-SPIR. The delineation of pancreas wall with TSE-SPIR(1.90), GE-PROSET(2.80) were significantly improved using GE-PROSET. In conclusion, TSE-SPIR fat suppression was superior to GE-PROSET fat suppression in T2 WI FS abdominal MRI.

• Journal of Gastric Cancer
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• v.5 no.4 s.20
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• pp.252-259
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• 2005

To clarify the clinicopathologic features of small-cell carcinomas (SCC) of the stomach, we reviewed three cases of surgically treated SCC. The first case was a pure SCC, with severe pancreatic invasion and peritoneal seeding. A gastro-jejunostomy was performed. Postoperative chemotherapy was performed with CDDP and VP-16 (8 cycles) but showed disease progression (PD); a consecutive chemotherapy with CDDP and irinotencan (2 cycles) also showed PD. A third line with CDDP, VP16, ifosfamide, and mesna was followed by a 4th line (CDDP and Taxol). The male patient died with liver metastasis and peritoneal seeding 14 months after the operation. The second case was a SCC mixed with a poorly differentiated adenocarcinoma. Profound lymphadenopathy and liver metastasis were found. Two cycles of preoperative chemotherapy with TS-1 and CDDP were performed, which showed nearly complete remission for lymphadenopathy and partial response for the primary tumor site and liver metastatic lesion. A total gastrectomy and extended lymphadenectomy was performed. There were no viable cancer cells in 35 retrieved lymph nodes. Postoperative chemotherapy using the same regimen was performed for 4 cycles. Enlarged liver metastasis was found at the follow-up CT scan, so a posterior segmentectomy of liver was performed. After liver surgery, the chemotherapy regimen was changed to irinotecan and cisplatin. This male patient has been in good health for the f4 months since gastric surgery. The third case was a pure SCC, and a subtotal gastrectomy was performed curatively. That male patient received 5 cycles of TS-1 and is still in good health 14 months after operation.

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

• Tuberculosis and Respiratory Diseases
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• v.66 no.6
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• pp.457-462
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• 2009

While receiving appropriate treatment, patients with tuberculosis occasionally have unusual, paradoxical reactions, with transient worsening of lesions or the development of new lesions. This report is a case of tuberculosis brain abscess and tuberculosis peritonitis with intra-abdominal abscess that developed during appropriate anti-tuberculosis chemotherapy. A 45-year-old male patient had been diagnosed as with all-drug susceptible pulmonary tuberculosis with pleurisy. Subsequently, the patient underwent standard treatment with anti-tuberculosis therapy; the pulmonary lesions improved. Three months after initial treatment, the patient developed brain abscesses and peritonitis. With the addition of corticosteroid treatment, the patient's neurologic symptoms were relieved. Exploratory laparotomy with surgical drainage was performed and a diagnosis of tuberculosis peritonitis was confirmed on biopsy. Anti-tuberculosis therapy was continued for 19 months, the patient improved eventually without further complications, although the therapeutic regimen had not been altered. In this case, the paradoxical response to treatment may have been involved in the pathogenesis of disease.

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

• Proceedings of the Korea Water Resources Association Conference
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• 2007.05a
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• pp.805-809
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• 2007

최근 도시의 발달은 하상공간에 대한 이용도를 높이는 방향으로 개발이 진행되어가는 추세이며, 하상도로 및 하상주차장의 이용은 이제 도시 내에서 이용 가능한 마지막 여유 공간으로 인식될 정도로 그 의존도가 높아져가고 있다. 그러나 하상공간의 활용도가 높아져갈수록 도시홍수의 발생으로 인한 대피문제가 발생하게 되고 돌발홍수로 인하여 하상도로의 차단 혹은 하상 주차장에 주차된 차량의 소거가 늦어지는 경우 고스란히 피해를 보게 되는 등 그 부작용도 계속 증가되고 있다. 도시홍수의 특성을 살펴보면 국지성 돌발 강우에 의한 유량의 급격한 증가와 짧은 유하시간, 작은 유역면적 등에 의하여 주요 예보지점까지의 도달시간이 매우 짧아 수문학적 홍수예측 모형을 이용하여 홍수예측 업무를 수행하는데 선행시간을 충분히 확보할 수 없다는 단점을 지니고 있다. 이에 따라 본 연구에서는 기존의 하천시스템에 대한 설계 등을 목적으로 하여 모형의 적용을 통한 시뮬레이션 기법을 적용하고 이를 통하여 홍수 예경보를 발령하기에는 선행시간의 확보(대피시간의 확보)라는 측면에서 상당한 어려움을 지닐 수 있으므로 시시각각으로 측정되는 실시간 수위측정 자료 및 실시간 강우자료를 이용하여 모형의 수행과정을 생략하고 하천의 수위변동을 직접 예측하고 대피할 수 있는 시나리오 기반의 수문모형을 개발하였다. SPSS를 사용한 통계학적 모형을 대전광역시 3대 하천에 대하여 적용한 결과 예측자료가 실측자료를 고수위 및 저수위 부근에서 정확히 모의하지 못하는 경향이 나타났으나 경계 및 위험수위를 설정하고 이를 넘어가는 시점에 대한 예측을 하는 홍수경보 시점 예측에는 효율적인 적용성을 나타내었다.씬 간편하면서도 정확도가 높아서, 환경방사성 스트론튬의 정량분석에 적절히 사용될 수 있다.e form of 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,

• Applied Microscopy
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• v.36 no.3
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• pp.183-194
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• 2006

The threadlike structures of fascia were examined by tight and electron microscopy. In order to distinguish its tissue organization, we used staining methods including hematoxylin-eosin, Masson's trichrome, Van Gieson's collagen fiber stain and Kluver-Barrera's luxol fast blue for nerve stain. Under the light microscope, the threadlike structures were composed of many collagen fibers and nerve. In higher magnification, they looked like as the bundle of tubular structures. Many myoid cell-spindle nuclei were observed in the tissue, which were taken from the fascia. It was identical with Bonghan duct known as one of meridian network theory. In the early 1960's the North Korean Bong-Han Kim showed the anatomical structures of the acupuncture points, and explained the meridian system as the concrete duct network system. According to Bonghan theory the Bonghan ducts spread throughout the body Because it is believed that the duct could have the role of signal pathway, the theory was reinvestigated in these days. All of the threadlike structures isolated from fascia shows the abundance of collagen fibers. The electron microscope examination (TEM) could confirm the well arranged collagen fiber and nerve. This investigation reveals that superficial Bohghan duct are nerve fiber parallel running with collagen fibers. We conjectured that the intermingled structure of collagen fiber, blood vessel and nerve fiber might have the role of meridian system. And the more, regardless of histological research, the study on collagen fiber as response transmitter in acupuncture treatment are in need.