Esophageal cancer is an aggressive disease with a poor prognosis. Recently, every effort has been made to improve the long term survival, but the general prognosis for patients with this disease remains poor. In this study, we reviewed 8 years of experiences with esophageal cancer patients managed in our department at Dong-A University Hospital and evaluated the effectiveness of cervical lymph node dissection performed selectively. Material and Method: From January 1995 to August 2003, 70 patients underwent esophagectomy for esophageal cancer in our department. Among them, 51 patients who underwent curative resection, had no double primary tumors and no neoadjuvant therapy were analyzed retrospectively. In most patients, intrathoracic esophagectomy and cervical esophago-gastrostomy was performed. Since 1997, 3-field lymph node dissection was performed selectively. Result: There were 46 men and 15 women. The median age was 60 years. The tumor was located in the upper third part in 10 patients (19%), middle third in 21 (41%), and lower third in 20 (40%). Majority of the patients (90%) had squamous cell carcinoma. Cervical anastomosis was made in 41 patients, and intrathoracic anastomosis in 10. 2-field lymph node dissection was done in 40 patients, and 3-field lymph node dissection in 11. The pathologic staging were as follows: stage I in 9 patients (17.6%), IIA in 20 (39.2%), IIIB in 7 (13.7%), III in 11 (21.6%), IVA in 2 (3.9%), and IVB in 2 (3.9%). The in-hospital mortality was 3.9% (2 patients) and complications occurred in 24 patients (47%). Overall actuarial 1, 3, and 5-year survival rates were 74.4%, 48.4%, and 48.4% including operative mortality. The 4-year survival rate did not differ significantly between 3-field lymph node dissection group (50.5%) and 2-field lymph node dissection group (48.9%). In 3-field lymph node dissection group, the respiratory complications were more frequent and operative time was significantly longer. Conclusion: We think that curative resection for esophageal cancer can be performed with acceptable mortality, and aggressive surgical approach may improve the long term survival. even for advanced stages. Effectiveness of 3-field lymph node dissection needs further investigations.
Journal of The Korean Association For Science Education
/
v.36
no.6
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pp.959-968
/
2016
In this study, the Delphi Method was conducted to extract variables as effects of integrated education. Forty-six experts engaged in both the integrated education and research fields participated in this study. The Delphi survey was conducted for three rounds. In the first round, an open questionnaire was given asking variables possibly considered as effects of integrated education. In the second round, variables induced from analysis of the first survey results were given and the degree of agreement for each variable was determined according to the Likert scale. In the third round of the survey, mean, standard deviation, and the first and third quartile calculated using the results of the second survey were given to experts to determine their degree of assent. In addition, categories for variables were suggested. The degree of agreement for appropriateness of categorization and relative importance were determined As a result, a total of 18 variables were chosen except for career awareness. They were categorized according to their definition and properties into five categories: 'creativity' (flexible thinking, associative thinking, intuitive thinking, creative thinking), 'problem solving' (meta-cognition, problem recognition and solving, critical thinking, decision making ability, ability of knowledge application, knowledge and information processing skills), 'integrative perception and sensitivity' (concern and interest in various disciplines, understanding and acceptance of difference, integrative thinking), 'interpersonal relations' (communication skills, cooperation), and 'disciplinary literacy' (humanistic imagination, basic knowledge and literacy of each discipline, academic motivation). The degree of agreement was high in variables included in 'creativity' and 'problem solving' categories and the frequency of choosing the importance was high in variables included in 'integrative perception and sensitivity'. The educational implication related to implementation and practice of integrated education were discussed on the basis of results.
Jang, Tae Won;Park, Jung Pil;Kim, Hee Kyoo;Ok, Chul Ho;Jeung, Tae Sig;Jung, Maan Hong
Tuberculosis and Respiratory Diseases
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v.57
no.3
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pp.257-264
/
2004
Background : There are many combinations of treatment for locally advanced non-small cell lung cancer (NSCLC). Recent studies have showed the efficacy of concurrent chemoradiotherapy (CCRT) in NSCLC. At present, however, there is no consensus about the optimal dosages and timing of radiation and chemotherapeutic agents. The aims of study were to determine the feasibility, toxicity, response rate, and survival rate in locally advanced NSCLC patients treated with doxetaxel and cisplatin based CCRT. Method : Sixteen patients with unresectable stage III NSCLC were evaluated from May 2000 until September 2001. Induction chemoradiotherapy consisted of 3 cycles of docetaxel (75 $mg/m^2/IV$ on day 1) and cisplatin (60 $mg/m^2/IV$ on day 1) chemotherapy every 3 weeks and concomitant hyperfractionated chest irradiation (1.15 Gy/BID, total dose of 69 Gy) in 6 weeks. Patient who had complete or partial response, and stable disease were applied consolidation chemotherapy of docetaxel and cisplatin. Results : All patients showed response to CCRT. Four patients achieved complete response (25%), partial responses in 12 patients (75%). The major common toxicities were grade III or more of neutropenia (87.3%), grade III esophagitis (68.8%), pneumonia (18.8%) and grade III radiation pneumonitis (12.5%). Thirteen patients were ceased during follow-up period. Median survival time was 19.9 months (95% CI; 4.3-39.7 months). The survival rates in one, two, and three years are 68.7%, 43.7%, and 29.1%, respectively. Local recurrence was found in 11 patients (66.8%), bone metastasis in 2, and brain metastasis in 1 patient. Conclusion : The response rate and survival time of CCRT with docetaxel/cisplatin in locally advanced NSCLC were encouraging, but treatment related toxicities were high. Further modification of therapy seems to be warranted.
This study was aimed to describe the population dynamics and secondary production of Tapes philppinarum on Chohwa and Toksan tidal flats in Kwangyang Bay, from June 1994 to July 1995. The size distributions in shell length showed bimodal patterns from June 1994 to April 1995. Thereafter the distribution changed to the passage of time, indicating an increase in shell length. The mean densities decreased gradually with month. Chohwa A sustained highestdensity, followed by Chohwa B, Toksan C, and Toksan D. The recruitment of new year class occurred first on the upper tidal flat, and then moved to the lower tidal flat. The mean biomass in flesh dry weight of each year class increased in spring just before the spawning period, and thereafter decreased progressively. Annual mean biomass wasrecorded as 170.7 g m$\^$-2/ at Chohwa A, 220.7 g m$\^$-2/ at Chohwa B, 21.8 g m$\^$-2/ at Toksan C, and 45.2 g m$\^$-2/ at toksan D. Annual productions of Ruditapes philippinarum were estimated as 259.72 g m$\^$-2/ yr$\_$-1/ at Chohwa A, 359.79 g m$\^$-2/ yr$\_$-1/ at Chohwa B, 45.02 g m$\^$-2/ yr$\_$-1/ at Toksan c, 68.88 g m$\^$-2/ yr$\_$-1/ at Toksan D. Annual productions were much higher on Chohwa tidal flat than those on Toksan tidal flat. While P:B ratio were higher on Toksan tidal flat as 1.70 than those on Chohwa tidal flat as 1.58. In conclusion, the Chohwa tidal flat showed higher biomass and producion of Ruditapes philippinarum, whereas the Toksan tidal flat showed higher P:B ratio. The total amount of potential food might influence on the density, biomass nad produciton, whereas the amount of food and space per individual might influence on the growth rate and P:B ratio.
Journal of agricultural medicine and community health
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v.27
no.1
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pp.87-98
/
2002
This study is to reveal the overall level of loneliness, depression and social supports of the elderly in rural area of Korea. The interview survey was performed in February 2001 with structured questionnaires to 486 respondents of 65 years or more of age who lived in Muan-gun area. The questionnaire was the revised translation of Japanese Elderly Study Which was composed of general characteristics, Japanese Loneliness Scale, abridged General Depression Scale(GDS) and Duke University social support Inventory. The following analyses adopted the analysis of covariate, t-test, and Chi- squire were used for some of the cross- sectional analyses. Average age of 486 respondents was 73.9 years old. 58.0% of the respondents noticed their partner or son as the primary consultant for the stressful situation. 56.2% of the respondents experienced the loss of their marital partner, health and/or friends. Average score of loneliness, GDS and social supports of the respondents that was each $35.54{\pm}8.38$, $7.23{\pm}2.21$ and $26.01{\pm}.90$. The overall level of depression seemed to be low as the 'pleasure to be alive' and 'happiness' scored high while the 'state of anger' and 'ominous presentiment' scored low. The level of loneliness and depression was positively correlated while the relationships were negative between loneliness and support and between depression and social support. These results suggested that social and health promotional programmes be necessary for the elderly of rural area. Further research would be required to specify the necessities.
In domestic transitional zone design, there is regulation to prevent generation of irregular substructure behaviors that negatively influence in prevention of plasticity settlement on approach section and contact section as well as relieve overall track rigidity by reducing sectional foundation and track stiffness difference, but design guideline that considers dynamic behavior of transitional track in actual service line is very insignificant. Therefore in this study, characteristics of transitional track dynamic behaviors by substructure stiffness are researched and measured dynamic response of transitional track by substructure stiffness in order to prove correlation between substructure and track and calculate elasticity(stiffness) and track load of transitional track by using measurement and formula to provide basic information for developing design guideline considering dynamic behavior of service line transitional track.
The Baegdusan volcano is one of the most active volcanoes in northeastern Asia, and the 10th century eruption was the most voluminous eruption in the world in recent 2,000 years. During the period from 2002 to 2005, volcanic earthquakes and abnormal surface distortions by suspected subsurface magma intrusion beneath the volcano were observed in the Baegdusan area. Seismic activity has gradually increased with earthquake swarms during 2002-2003 and hundreds of seismic event in a day, especially annual peak of 2,100 in 2003. Then the number of seismic activity has declined since 2006 to the background level in 1999-2001. According to the typical frequency of volcanic earthquakes in the Baegdusan volcano, the frequency distribution of typical volcanic earthquakes between 2002 and 2005 indicates that all the main frequency of the earthquakes basically falls down less than 5 Hz and 5-10 Hz. These events are all the VT-B and LP events caused by the shallow localized fracture and intrusion of magma. The horizontal displacement measurement by GPS during the period from 2000 to 2007 of the Baegdusan stratovolcano area indicates that an inflated process has been centered at the summit caldera since 2002. The displacement between 2002 and 2003 reached at a maximum value of 4 cm. After 2003, the deformation rate of the volcano continued to decrease with unusual variation during the period from 2006 to 2007. After 2003 the vertical displacement uplift rate falls down gradually but still keeps in an uplift trend in northern slope. It is generally believed that when $^3He/^4He(R)$ in a gas sample from a hot spring exceeds $^3He/^4He(R)$ in the atmosphere, it can be concluded that mantle-source. And temperatures of hot springs are rising steadily to $83^{\circ}C$. It is unrest signals at the Baegdusan, which is potentially active. The Baegdusan volcano is now in unrest status, there is eruption threat in the near future. Intensified monitoring and emergency response plan for volcanic risk mitigation are urgent for the volcano.
Medaka(Oryzias latipes) and earthworm(Eisenia fetida) toxicity tests were carried out and ecological risk assessment in water and soil was performed with national monitoring data. NOEC of alachlor was $100\;{\mu}g\;L^{-1}$ in the medaka early life-stage test. Embryonic development, hatchability and time to hatching of medaka eggs were affected by this chemical. The $LC_{50}$ and NOEC of alachlor were $94.1\;mg\;kg^{-1}\;and\;55.0\;mg\;kg^{-1}$, respectively, in the earthworm acute toxicity test. The environmental monitoring has been carrying out by NIER since 1999. Exposure levels of alachlor in water and soil were $ND{\sim}0.54\;{\mu}g\;L^{-1}\;and\;ND{\sim}0.9\;{\mu}g\;kg^{-1}$, respectively, in national monitoring data which had been performed from 2000 to 2004. The measured water and soil exposure levels were applied to evaluate the environmental risk assessment. The PNEC of alachlor in water and in soil were determined as $1\;{\mu}g\;L^{-1}\;and\;55.0\;{\mu}g\;kg^{-1}$, respectively using the safety factors which were suggested in EU and OECD. The HQs (PEC/PNEC) were determined to be below 1 for both water and soil when the maximum exposure levels ($0.54\;{\mu}g\; L^{-1}$ in water and $0.9\;{\mu}g\;kg^{-1}$ in soil) were applied. Conclusively, our study indicated that there was not significant ecological risk of alachlor in water and soil of our monitoring sites.
This study reported on the phytoplankton community and seasonal changes in the Seoul passage section and downstream in the Han River in 2012. Field samples were collected monthly from the upper (Paldang), middle (Cheongdam), and downstream(Seongsan) areas of the Seoul passage section. Water temperature, DO, pH, and conductivity were measured at each station. All environmental factors measured were recorded similarly at the three stations. The water temperature ranged from 2 to 30℃ and the dissolved oxygen ranged from 4.8 to 9.1 mg L-1, showing typical patterns of temperate regions. The phytoplankton cell concentrations ranged from 990 cells mL-1 (Paldang, December) to 2.9×104 cells mL-1 (Seongsan, March), and the chlorophyll-a content showed similar patterns to the cell numbers. The phytoplankton community was comprised of 75 genera and 95 species, including 37 diatoms, 29 Chlorophyta, 11 cyanobacteria, and two dinoflagellates. The number of species that appeared seasonally varied greatly, from nine species (Paldang, May) to 35 species (Cheongdam, December). Diatoms were the most dominant in all stations and seasons, except in summer. In contrast, chlorophytes and cyanobacteria showed sporadic high numbers in the summer and fall seasons. Four diatoms Stephanodiscus hantzschii f. tenuis, S. hantzschii, Fragilaria sp., and Aulacoseira spp., a chlorophyte Actinastrum hantzschii, and a cyanobacterium Microcystis sp. were each present in proportions greater than 10%. This study provides fundamental data from phytoplankton communities and environmental factors in the Han River for understanding water quality for long-term environmental monitoring.
Seo, Jung Ho;Nam, Ga Yeon;Park, Kyung Hee;Byun, Shin Yun;Park, Su Eun
Pediatric Infection and Vaccine
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v.17
no.1
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pp.1-8
/
2010
Purpose : Recently, vancomycin-resistant enterococci (VRE) have become one of the major nosocomial pathogens in Korea. However, there have been few studies on the epidemiology of VRE colonization among neonates. In this study, we investigated the prevalence of VRE colonization, risk factors for VRE, and how to control the spread of VRE infection in the Neonatal Intensive Care Unit (NICU) of Pusan National University Hospital (PNUH). Methods : We retrospectively reviewed medical records of 192 neonates who were admitted to the NICU of PNUH from March 2006 to March 2007. Surveillance cultures from rectal swabs for detecting VRE were obtained weekly during the study period. We analyzed the prevalence of VRE and various risk factors. Results : The rate of VRE colonization among NICU patients was 25% (48/192). Thirty five of these VRE colonized patients were transferred to the NICU from other local hospitals. Compared with the non-VRE group, the risk factors associated with VRE colonization were lower birth weight, congenital heart disease, applied mechanical ventilation, use of a central venous catheter, chest tubing, a history of surgery, and use of antibiotics. Conclusion : VRE colonization among patients admitted to the NICU is rapidly increasing. Monitoring and managing premature neonates from the beginning of the birth process, avoiding many invasive procedures, avoiding antibiotics such as vancomycin and third generation cephalosporin are important for preventing the emergence and spread of VRE colonization in the NICU.
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