• Journal of Gastric Cancer
• /
• v.8 no.2
• /
• pp.91-96
• /
• 2008

Purpose: The early detection of gastric cancer and accuracy of preoperative staging has currently been on the increase due to the development of endoscopy and imaging techniques, but there are still many cases of advanced gastric cancer detected at the first diagnosis and there are also many cases of stage IV gastric cancer diagnosed after a postoperative pathological examination. Although the prognosis of stage IV gastric cancer is very poor, this study was performed to determine the value of the use of aggressive treatment determined after a clinical analysis. Materials and Methods: We retrospectively analyzed 150 patients that were diagnosed with stage IV gastric cancer among 1376 patients who underwent a laparotomy for gastric cancer from January 1994 to December 2006. Results: Of the 150 patients with stage IV gastric cancer who underwent a laparotomy, there were 104 men and 46 women. The mean patient age was 57.8 years (age range, 28~93 years). A subtotal gastrectomy or total gastrectomy was performed in 119 patients and 31 patients underwent an explorative laparotomy. The mean survival time of patients that underwent a gastrectomy and patients that did not undergo a gastrectomy was 722 days (range, 14~4,559 days) and 173 days (range, 16~374 days), respectively this result was statistically significant. When patients that underwent a gastrectomy were classified according to the TNM stage, the mean survival time of 33 patients with stage T4 disease was 534 days (range, 17~3,378 days) and the mean survival time of 63 patients with stage N3 disease was 521 days (range, 14~4,190 days), but there was no statistical significance. Chemotherapy was administered to 98 patients and 52 patients did not receive chemotherapy. The mean survival time of patients that received chemotherapy was 792 days (range, 36~4,559 days) and the mean survival time of patients that did not receive chemotherapy was 243 days (range, 14~2,413 days), with statistical significance. Conclusion: If there is no evidence of distant metastasis in stage IV gastric cancer, one can expect improvement of the survival rate by the use of aggressive treatment, including curative gastric resection with radical lymph node dissection and chemotherapy.

• Journal of Korean Orthopaedic Sports Medicine
• /
• v.2 no.2
• /
• pp.168-175
• /
• 2003

Fracture about proximal humerus may be classified as the articular segment or the anatomical neck, the greater tuberosity, the lesser tuberosity, and the shaft or surgical neck. Now, usually used, Neer's classification is based on the number of segments displaced, over 1cm of displaced or more than 45 degrees of angulation , rather than the number of fracture line . Absolute indication of a operative treatment a open fracture, the fracture with vascular injury or nerve injury , and unreductable fracture-dislocation . Inversely, the case that are severe osteoporosis, and eldly patient who can't be operated by strong internal fixation is better than arthroplasty used by primary prosthetic replacement and early rehabilitation program than open reduction and internal fixation. The operator make a decision for the patient who should be taken the open reduction and internal fixation, because it's different that anatomical morphology, bone density, condition of patient. The operator decide operation procedure. For example, percutaneous pinning, open reduction, plate & screws, wire tension bands combined with some intramedullary device are operation procedure that operator can decide . The poor health condition for other health problem, fracture with unstable vital sign and severe osteoporosis , are the relative contraindication. The stable fracture without dislocation is not the operative indication . The radiologic film of the prokimal humerus before the operation can not predict for fracture evaluation. It's necessary to good radiologic film for evaluation of fracture form. The trauma serise is better than the other radiologic film for evaluation. The accessary radiologic exam is able to help for evaluation of bone fragment and anatomy. The CT can be helpful in evaluating these injury, especially if the extract fracture type cannot be determined from plain roenterogram of the proximal humerus, bone of humerus head. If the dislocation is severe anatomically , we could consider to do three dimentional remodelling. The MRI doing for observing of bony morphology before the operation is not better than CT If we were suspicious of vascular injury, we could consider the angiography.

• The Korean Journal of Nuclear Medicine
• /
• v.32 no.4
• /
• pp.325-331
• /
• 1998

Purpose: We evaluated the importance of redistribution and 24 hour reinjection images in T1-201 SPECT assessment of myocardial viability after acute myocardial infarction (AMI). Materials and Methods: We performed dipyridamole stress-4 hour redistribution-24 hour reinjection T1-201 SPECT in 43 patients with recent AMI (4-16 days). The myocardium was divided into 16 segments and perfusion grade was measured visually with 4 point score from 0 to 3 (absent uptake to normal uptake). A perfusion defect with stress score 2 was considered moderate. A defect was considered severe if the stress score was 0 or 1 (absent uptake or severe perfusion decrease). Moderate defect on stress image were considered viable and segments with severe defect were considered viable if they showed improvement of 1 score or more on redistribution or reinjection images. We compared the results of viability assessment in stress-redistribution and stress-reinjection images. Results: On visual analysis, 344 of 688 segments (50%) had abnormal perfusion. Fifty two (15%) had moderate perfusion defects and 292 (85%) had severe perfusion defects on stress image. Of 292 severe stress defects, 53 were irreversible on redistribution and reversible on reinjection images, and 15 were reversible on redistribution and irreversible on reinjection images. Two hundred twenty four of 292 segments (76.7%) showed concordant results on stress-redistribution and stress-reinjection images. Therefore 24 hour reinjection image changed viability status from necrotic to viable in 53 segments of 292 severe stress defect (18%). However, myocardial viability was underestimated in only 5% (15/292) of severe defects by 24 hour reinjection. Conclusion: The 24 hour reinjection imaging is useful in the assessment of myocardial viability. It is more sensitive than 4 hour redistribution imaging. However, both redistribution and reinjection images are needed since they complement each other.

• Korean Journal of Environmental Biology
• /
• v.19 no.1
• /
• pp.49-58
• /
• 2001

This study aims to compare and analyze the environment of natural parks and Ulleung island using the plant taxa classified by five degrees based on their distributional ranges. The scores differentially given based on the importance of each degree; taxa belonging to the fifth degree are given to 20 scores each, fourth 10, third 5, second 3.3, and first 2.5, respectively. The total assessed scores were ranked as Mt. Halla, Seorak, Jiri, Deokyu, Is. Ulleung, Mt. Sobaek, Odae, Palgong, Chink, Taebaek, Songni, Juwang, Gaya, Duryun, Gaeryong, Bukhan, Naebyeon, Worak, Naejang, Cheongryang, Naeyeon, Myeongii, Jokye, Mudeung, Wolchul, Geumo, Juheul, Biseul, Hwangmae, Jangan, Seonun, Moak, Seonam, Chilgap, and Gibaek, in order, respectively. It is suggested that the natural environments assessing more than 1,000 of total scores such as Mt. Halla and Mt. Deokyu are regarded as the most excellent ones, and those between 700 to 1,000 of total scores such as Is. Ulleung and Mt. Odae are regarded as relatively excellent ones. Natural parks scored between 500 to 700 such as Mt. Palgong and Mt. Gaya are regarded as good ones and parks scored between 300 to 500 such as Mt. Duryun and Mt. Mudeung are regarded as normal ones. The area assessed less than 300 of total scores such as Mt. Wolchul and Mt. Gibaek are regarded as the most inferior ones. The total scores of the national parks are generally higher than those of the provincial and county parks. In addition, Ulleung island has a total of 882.9 scores. Therefore, according to the IUCN the Ulleung island should be included in the criterion of the preservative model of natural ecosystem, suggested by Ministry of Environment. At the same time, Ulleung island should be included to the superior model of natural scenery resources by its uniqueness of topography, geography and natural environments. Ulleung island is assessed as having relatively excellent natural environments as compared with other national parks, suggesting that the island should be designated as a new national park.

• Radiation Oncology Journal
• /
• v.26 no.4
• /
• pp.229-236
• /
• 2008

Purpose: The purpose of this study was to evaluate the impact of the use of external radiation therapy (ERT) in terms of survival and compliance in patients with anaplastic thyroid carcinoma. Materials and Methods: The medical records of 17 patients with anaplastic thyroid carcinoma treated with ERT between 1993 and 2002 were retrospectively reviewed. ERT was administered after surgery in 14 patients and after a biopsy in three patients. Among the 14 patients who had undergone surgery, nine underwent a curative resection and five underwent a palliative resection. Six patients had associated well-differentiated thyroid carcinomas and 14 patients were diagnosed with a tumor size exceeding 5 cm. The radiation dose ranged from $6{\sim}70\;Gy$ (median dose, 37.5 Gy). Eleven patients completed the planned course of ERT, whereas six patients did not. The follow-up period ranged from $1{\sim}104$ months (median, 5 months; mean, 20 months). Results: Five patients started the ERT without the presence of a gross mass and all of the patients competed ERT without a re-growth of tumor. Twelve patients (four patients after a curative resection, five patients after a palliative resection and three patients after a biopsy) started ERT with a gross mass present and only six patients were able to complete the planned course of ERT. Among the six patients who completed ERT, two patients showed a marked regression of the tumor mass, whereas two patients showed slight regression and two patients showed no response. The median survival was five months (range, $1{\sim}104$ months) and the mean survival was 21 months. The overall survival was 41% at 1-year, 24% at 2-years and 12% at 5-years. Significant prognostic factors included the number of primary tumors present, tumor size, whether surgery was performed and completion of ERT as planned. Long-term survivors showed a tendency of having smaller sized initial tumors and smaller sized pre-ERT tumors than the short-term survivors. Conclusion: This study suggests that patients with a small initial tumor (${\leq}5\;cm$), which was treated by surgery (curative resection or palliative resection) before ERT, and without rapid re-growth of the mass seen at the surgical site at the beginning of the ERT course, would be the best candidates for postoperative ERT. In contrast, patients with a large initial tumor (>5 cm) and did not undergo surgery before ERT or that rapid re-growth of the mass was observed at the surgical site are likely to have a short survival time, along with the interruption of ERT. In these cases, the role of ERT is very limited and the omission of ERT could be considered.

• Journal of Chest Surgery
• /
• v.39 no.11 s.268
• /
• pp.838-843
• /
• 2006

Background: The lung is the most common site of metastatic colorectal cancer comprising 10% of all curative resection of colorectal cancer. The reported 5 year survival rate varies among institutions. The purpose of the present study was to present the retrospective analysis of colorectal metastatic lung cancer surgery at our institution. Material and Method: A total of 61 patients undergoing surgery for metastatic colorectal lung cancer between July 1996 and December 2003 were included in the present study. The stage of the primary colorectal cancer, site of pulmonary metastasis, method of lung resection, the number and size of the metastatic nodules, the recurrence rate, and survival were assessed. Result: The 3 and 5 year survival rates were 66% and 41%, respectively. No significant risk factors were identified among the studied variables by either univariate or multivariate analysis. The mean disease free survival rate was 17 months. The most common recurrent site was lung, and among these patients, 3 underwent a second operation and two are still alive. Conclusion: The results of the above data suggest that pulmonary resection of metastatic lung cancer in select patients after curative resection of colon cancer may be a good therapeutic option with the potential for excellent results.

• 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 the Korean Society of Food Science and Nutrition
• /
• v.43 no.1
• /
• pp.141-150
• /
• 2014

This study was carried out to investigate the effects of nutrition education on blood glucose in type 2 diabetic patients with low income. There were 50 (27 male and 23 female) study subjects with type 2 diabetes under national medical support, and the monthly income in most of them was less than 500,000 won. Anthropometric measurement, biochemical blood indices, food intake, dietary habits, and nutrition knowledge of the subjects were investigated before nutrition education. Nutrition education was conducted 6 times within 12 weeks. After nutrition education, the glycosylated hemoglobin was significantly decreased (male: $8.4{\pm}1.6%$ to $8.0{\pm}1.7%$, female: $8.3{\pm}1.6%$ to $8.0{\pm}1.3%$) and the total cholesterol was also significantly decreased in both groups. The group of female resulted in a significant decrease in fasting blood glucose ($169.7{\pm}28.2$ mg/dL to $152.8{\pm}22.0$ mg/dL) and triglyceride ($177.8{\pm}56.3$ mg/dL to $162.3{\pm}36.1$ mg/dL), but the group of male did not show a significant decrease in fasting blood glucose and triglyceride. Nutritional knowledge and dietary habit scores of the subjects were significantly improved after nutrition education. The results demonstrate that nutrition education for type 2 diabetic patients with low income are effective in improving their blood glucose.

• Journal of Chest Surgery
• /
• v.37 no.12
• /
• pp.1003-1009
• /
• 2004

Mechanical circulatory support (MCS) has been used for myocardium failure, but moreover, it may be essential for the life support in cardiac arrest or cardiogenic shock. Many commercial devices can be used effectively for the long-term support. However, there are some limitations in the aspects of the cost and technical support by production company. Short-term support with centrifugal type has been reported numerously with the purpose of bridging to heart transplantation or recovery. We successfully treated 5 patitents who were in the status of cardiogenic shock (n=3) or arrest (n=2) with the technique of extracorporeal life support system (ECLS) or left ventricular assist device (LVAD) using the centrifugal type pump. The MCS were performed emergently (n=2) under cardiac arrest caused by ischemic heart disease, and urgently (n=3) under cardiogenic shock with ischemic heart disease (n=1) or acute fulminant viral myocarditis (n=2). All patients were weaned from MCS. Complications related to the use of MCS were bleeding and acute renal failure, but there were no major complications related to femoral cannulations. Mechanical circulatory support may be essential for the life support and rescue in cardiac arrest or cardiogenic shock.

• Proceedings of the Korean Society of Propulsion Engineers Conference
• /
• 2000.04a
• /
• pp.16-16
• /
• 2000

충격파를 포함하는 초음속 유동을 해석하는 수치해법 중에서 많이 사용되어진 것은 엄밀 및 근사 리만 해법과 플럭스 분할 기법들로서 이들은 Euler 방정식에 기반을 두고 선형 또는 비선형파의 상호작용을 풍상 차분법으로 기술하는 방법들이다. 이러한 수치기법들은 과거 광범위하게 사용되어 왔으나 최근 여러 가지 단점이 발견되었다. 이와 같은 문제점을 극복하고자 입자의 통계적인 운동을 기술하는 기체 운동론에 근거하여 BGK 수치기법이 제시되었다. 이는 비충돌 볼츠만 방정식으로부터 입자의 수준에서 플럭스 분할 기법 형태의 풍상차분법을 구현하는 것으로 볼츠만 방정식의 충돌항을 BGK 모델로 대치하고 이것의 적분해로부터 수치 플럭스를 구한다. 이 수치기법은 기존의 리만해법에 비하여 수치적으로나 물리적으로 매우 타당한 성질인 강건성, 정확성, 엔트로피 조건, 양수보존성 등을 가지고 있음이 밝혀졌다. 이와 같은 수치기법을 사용하여 로켓 노즐 내의 아음속, 천이음속, 초음속에서의 유동장 해석을 위한 프로그램을 작성하였다. 시간 적분에 대하여는 정상 상태의 계산을 위하여 내재적 시간 적분 방법을 사용하였으며, 공간 이산화 방법으로는 임의의 제어체적에 대하여 적분형 보존 방정식을 적용하는 유한 체적법을 사용하였다. 초음속 입구 유동과 출구에서 초음속과 저음속 유동의 두가지 경우를 고려하여 얻은 결과를 기존의 연구 결과와 비교하여 본 결과 잘 일치하였다. 입구 유동이 저음속이고 출구 유동이 초음속인 경우에 대하여도 해석결과가 실험결과와 잘 일치하였다. 상대적으로 낮은 온도, 압력 조건과 높은 온도, 압력 조건을 가지는 고체 로켓 모터 노즐 내의 유동을 해석하였다. 이들 해석 결과를 전압, 전온도로 표준화시킨 결과 서로 일치하였으며, 파라서 저온, 저압에서 얻은 결과도 표준화시킬 경우, 고온, 고압에서도 사용될 수 있음을 알 수 있었다.의 영향에 초점을 맞추었다.다고 판단되며 배기 가스 자체에 대기 공기중에 함유되어 있던 습기가 얼어붙는(Icing화) 문제가 발생하기 때문에 배기가스의 Icing을 방지하기 위하여 압축기 끝단에서 공기를 추출하여 배기부분에 송출할 필요성이 있는 것으로 판단되었다. 출구가스의 기체 유동속도가 매우 빠르므로 (100-l10m.sec) 이를 완화하기 위한 디퓨저의 설계가 요구된다고 판단된다. 또 연소기 후방에 물을 주입하는 경우 열교환기 및 기타 부분품에 발생할 수 있는 부식 및 열교환 효율 저하도 간과할 수 없는 문제로 파악되었다. 이러한 기술적 문제가 적절히 해결되는 경우 비활성 가스 제너레이터는 민수용으로는 대형 빌딩, 산림, 유조선 등의 화재에 매우 적절히 사용되어 질 수 있을 뿐 아니라 군사적으로도 군사작전 중 및 공군 기지의 화재 그리고 지하벙커에 설치되어 있는 고급 첨단 군사 장비 등의 화재 뿐 아니라 대간첩작전 등에 효과적으로 활용될 수 있을 것으로 판단된다.가 작으며, 본 연소관에 충전된 RDX/AP계 추진제의 경우 추진제의 습기투과에 의한 추진제 물성 변화는 미미한 것으로 나타났다.의 향상으로, 음성개선에 효과적이라고 사료되었으며, 이 방법이 편측 성대마비 환자의 효과적인 음성개선의 치료방법의 하나로 응용될 수 있으리라 생각된다..7%), 혈액투석, 식도부분절제술 및 위루술·위회장문합술을 시행한 경우가 각 1례(2.9%)씩이었다. 13) 심각한 합병증은 9례(26.5%)에서 보였는데 그중 식도협착증이 6례(17.6%), 급성신부전증 1례(2.9%), 종격동기흉과 폐염이 병발한 경우와 폐염이 각 1례(2.9%)였다. 14) 식도경 시행회수는 1회가 17례(54.8%), 2회가 9례(29.0%), 3회 이상이 5례(16.1%)였다.EX>$IC_{50}$/ 값이 210 $\mu\textrm{g}$<