• Title/Summary/Keyword: 전해

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The Early Experience with a Totally Laparoscopic Distal Gastrectomy (전(全)복강경하 원위부 위절제술의 초기 경험)

  • Kim Jin Jo;Song Gyo Young;Chin Hyung Min;Kim Wook;Jeon Hae Myoung;Park Cho Hyun;Park Seung Man;Lim Keun Woo;Park Woo Bae;Kim Seung Nam
    • Journal of Gastric Cancer
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    • v.5 no.1
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    • pp.16-22
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    • 2005
  • Purpose: In Korea, the number of laparoscopy-assisted distal gastrectomies for early gastric cancer patients has been increasing lately. Although minimally invasive surgery is more beneficial, no reported case of a totally laparoscopic distal gastrectomy has been reported because of difficulty with intracorporeal anastomosis. This study attempts, through our experiences, to determine the feasibility of a totally laparoscopic distal gastrectomy using an intracorporeal gastroduodenostomy in treating early gastric carcinoma. Materials and Methods: We investigated surgical results and clinicopatholgic characteristics of eight(8) patients with an early gastric carcinoma who underwent a totally laparoscopic distal gastrectomy at the Department of Surgery, Our Lady of Mercy Hospital, The Catholic University of Korea, between June 2004 and September 2004. The intracorporeal gastroduodenostomy was performed with a delta-shaped ananstomosis by using only laparoscopic linear staplers (Endocutter 45mm; Ethicon Endosurgery, OH, USA). Results: The operative time was $369.4\pm62.5$ minutes (range $275\∼465$ minutes), and the anastomotic time was 45.1\pm14.4$ minutes (range $32\∼70$ minutes). The anastomotic time was shortened as surgical experience was gained. The number of laparoscopic linear staplers for an operation was $7.1\pm0.6$. The number of lymph nodes harvested was $31.9\pm13.1$. There was 1 case of transfusion and no case of conversion to an open procedure. The time to the first flatus was 2.8$\pm$0.5 days, and the time to the first food intake was $4.1\pm0.8$ days. There were no early postoperative complications, and the postoperative hospital stay was $10.0\pm3.9$ days. Conclusion: A totally laparoscopic distal gastrectomy using an intracorporeal gastroduodenostomy with a delta-shaped anastomosis is technically feasible and can maximize the benefit of laparoscopic surgery for early gastric cancer.

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The Influences of Maintenance Hemodialysis on Sleep Architecture and Sleep Apnea in the Patients with Chronic Renal Failure (만성신부전 환자에서 혈액투석 유지요법이 수면구조 및 수면 무호흡에 미치는 영향)

  • Park, Yong-Geun;Lee, Sang-Haak;Choi, Young-Mee;Ahn, Seok-Joo;Kwon, Soon-Seog;Kim, Young-Kyoon;Kim, Kwan-Hyoung;Song, Jeong-Sup;Park, Sung-Hak;Moon, Hwa-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.6
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    • pp.824-835
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    • 1999
  • Background: Sleep-related breathing disorders are commonly found in patients with chronic renal failure and particularly, sleep apnea may have an influence on the long-term mortality rates in these patients. Maintenance hemodialysis is the mainstay of medical measures for correcting the metabolic derangements of chronic renal failure but it is uncertain whether it may alleviate sleep disorders including sleep apnea. Methods: Forty seven patients on maintenance hemodialysis were surveyed with the sleep questionnaire about their clinical symptoms related to sleep disorders. Among them, 15 patients underwent the polysomnography and their blood levels of urea nitrogen, creatinine, electrolytes and the arterial blood gases in the nights before and following hemodialysis were measured. Results: Forty(85.1%) of the 47 patients complained of the symptoms associated with sleep-wake cycle disturbances, 55.3% experienced snoring and 27.7% reported witnessed apneas. The duration of REM sleep increased significantly in the nights after hemodialysis compared to the nights without hemodialysis(p<0.05) and the percentage of total sleep time comprising NREM sleep decreased significantly in the nights following hemodialysis compared to the nights before hemodialysis(p<0.05). The percentage of total sleep time consisting of the stage 1 and 2 NREM sleep showed the trend for a decrease in the nights after hemodialysis(p=0.051), while the percentage of total sleep time comprising the stage 3 and 4 NREM sleep did not change between nights. The obstructive sleep apnea was more predominant type than the central one in both nights and there were no differences in the apnea index and the apnea-hypopnea index between the nights. The decrease in the blood level of urea nitrogen, creatinine, potassium and phosphorus was observed after hemodialysis(p<0.05), but the differences of parameters measured during polysomnography between the nights did not correlate with the changes of biochemical factors obtained on the two nights. Arterial blood gas analysis showed that pH was significantly greater in the nights after hemodialysis than in the nights before hemodialysis(p<0.05), but there were no correlations between the parameters examined during polysomnography and the parameters of arterial blood gas analysis(p<0.05). Conclusion: These results suggest that chronic renal failure is an important systemic disorder which is strongly associated with sleep disorders. Maintenance hemodialysis, although it is a widely accepted measure to treat chronic renal failure, did not significantly modulate the sleep architecture and the severity of sleep apnea. Thus, taking the patients with chronic renal failure into account, it is advisable to try not only to find a substantial way for correcting metabolic derangements but also to consider the institution of more effective treatments for sleep disorders.

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A Study on Corrosion according to Distance between Amalgam and Dissimilar Metals (아말감과 이종(異種)금속의 거리에 따른 부식에 대한 고찰)

  • Kim, Ju-won;Jeong, Eun-gyeong
    • Journal of dental hygiene science
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    • v.4 no.3
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    • pp.103-109
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    • 2004
  • The present study prepared 72 test samples - 24 made of amalgam alloy, 24 of Verabond (Ni-Cr alloy) for crown and 24 of Talladium $^{TM}alloy$ for denture - according to the manufacturers' manuals and general method in consideration of the width of the mesial-distal dental crown of the lower $1^{st}$ molar and MOD cavity in clinics, put them in a 200 ml beaker containing 80 ml of artificial saliva, and measured their galvanic corrosion at distances of 0 mm, 7 mm and 40 mm after 7 days. Isolated metals in the electrolyte such as Cu, Ag, Ni, Cr, Sn, Zn and Hg were quantitatively analyzed with Inductively Coupled Plasma - Atomic Emission Spectrometer (ICP-AES, JY-50P, VG Elemental Co. France), and from the results were drawn conclusions as follows. First, Cu, Sn, Ag, Hg and Zn were highly advantageous when amalgam contacted gold alloy compared to Ni-Cr alloy for crown and Talladium alloy for denture. In addition, although gold alloy was finest in terms of oral tissue and biocompatibility, it was most disadvantageous when it was with amalgam. Second, when amalgam contacted gold alloy, heavy metals such as Ni and Cr were not isolated at all because gold alloy did not contain such elements but Sn was isolated as much as $227.1{\pm}18.0035{\mu}g/cm^2$ although it was not included in the composition either. Hg was also isolated. These elements are assumed to have been isolated from amalgam itself. Third, when amalgam alloy was apart from gold alloy 0 mm, 7 mm and 40 mm, Cu and Ag showed significance but Hg did not. This suggests that gold alloy must not be used together with amalgam, and must not be used between dissimilar prostheses regardless of distance. Fourth, when amalgam alloy contacted Ni-Cr alloy for crown, Ag was not isolated from the amalgam, but Zn, Ni, Sn, Hg and Cu were isolated in order of quantity. Significance was observed according to distance - 0 mm, 7 mm and 40 mm. Hg was not isolated but heavy metals Ni and Cr were isolated. If amalgam alloy was in the opposite arch or it was apart from Ni-Cr alloy for crown, the isolation Hg was less than that when amalgam alloy contacted Ni-Cr alloy for crown. Fifth, when amalgam alloy contacted Talladium alloy for denture, significance was observed at distances of 0mm, 7 mm and 40 mm. Hg was not isolated but heavy metals Ni and Cr were isolated. If amalgam alloy was in the opposite arch or it was apart from Talladium alloy for denture, the isolation Hg was less than that when amalgam alloy contacted Talladium alloy for denture. Sixth, according to the result of ICPES test on Cu, Sn, Ag, Hg, Zn, Ni and Cr of amalgam alloy, gold ally, Verabond and Talladium alloy when these alloys contacted artificial saliva, significance was observed in Cu and Hg. Seventh, when amalgam alloy contracted two non-precious metals Ni-Cr alloy for crown and Talladium alloy for denture in artificial saliva, significance was observed in the isolated by-products of Hg, Ni and Cr according to distance.

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Clinical Analysis According to $p21^{Waf1/Cip1}\;and\;p27^{kip1}$ Expression in Gastric Cancer (위암에서의 $p21^{Waf1/Cip1}\;and\;p27^{kip1}$ 단백 발현)

  • Kim, Sin-Sun;Park, Yong-Geun;Jun, Kyong-Hwa;Jung, Hun;Song, Gyo-Young;Kim, Jin-Joo;Chin, Hyung-Min;Kim, Wook;Park, Cho-Hyun;Park, Seung-Man;Lim, Keun-Woo;Kim, Seung-Nam;Jeon, Hae-Myung
    • Journal of Gastric Cancer
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    • v.6 no.1
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    • pp.36-42
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    • 2006
  • Purpose: The $p21^{Waf1/Cip1}$ protein Inhibits the cell cycle by Inhibiting the phosphorylation at the $G1{\rightarrow}S$ check point, and the $p27^{kip1}$ protein similarly performs the suppressor function by controlling the p27-mediated G1 arrest. In this study, we analysed the clinical status and survival rates in correlations with p21 and p27 expression patterns in gastric cancer. Materials and Methods: Between 1993 and 1997, 192 patients who underwent surgeries in Catholic Medical Center were analysed retrospectively in this study. Immunohistochemical staining was performed and if the nuclei of the tumor cells were stained, we assumed those as positive results. Statistical analysis was based on clinicopathological findings and differences in survival rates. Results: The expression rate of p27 was 28.1% and 15.6% in p21 each. The ratio of T1-2(80.0%) was significantly high in p21 (+), but the ratio of T3-4 (50.6%) was slightly high in p21 (-). There was no statistical significance regarding other factors. The results in p27 was not much different from expression rate of p21 in T-stage. In addition, p27 expression in diffuse type (91.3%) was higher than in intestinal type (62.7%) by Lauren's classification (P<0.05). Also, there was no statistical significance in other factors. In the correlation of p21 and p27, p27 was positive when p21 was positive (53.5%). Conversely, p27 was negative when p21 was negative (76.5%, p<0.05). In the p21 and p27 combination test, there was higher rate of T1-2 (87.5%) in p21 (+)/p27 (+), and higher rate of T3-4 (58.1%) in p21 (-)/p27 (-) (P<0.05). Results showed higher rate of intestinal type (100%) in p21 (+)/p27 (+), and diffuse type (87.0%) was dominant in p21 (-)/p27 (-) (P<0.05) by Lauren's classification. Moreover, there was no statistical significance in the 5-year survival rate in the expression of p21 and p27, and the 5-year survival rate was highest in the case of p21 (+)/p27 (+) without statistical significance. Conclusion: In our study, $p21^{Waf1/Cip1}\;and\;p27^{kip1}$ expressed similar patterns. The expression of $p21^{Waf1/Cip1}\;and\;p27^{kip1}$ affected the degree of invasiveness of the tumor, and. Combined examination result revealed the correlation of $p21^{Waf1/Cip1}\;and\;p27^{kip1}$ with Lauren's classification and depth of invasion of the tumor. However, we assumed that little difference between the survival rates depending on expression of $p21^{Waf1/Cip1}\;and\;p27^{kip1}$ has limited their value as predictable prognostic indicators.

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A study on the Greeting's Types of Ganchal in Joseon Dynasty (간찰(簡札)의 안부인사(安否人事)에 대한 유형(類型) 연구(硏究))

  • Jeon, Byeong-yong
    • (The)Study of the Eastern Classic
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    • no.57
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    • pp.467-505
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    • 2014
  • I am working on a series of Korean linguistic studies targeting Ganchal(old typed letters in Korea) for many years and this study is for the typology of the [Safety Expression] as the part. For this purpose, [Safety Expression] were divided into a formal types and semantic types, targeting the Chinese Ganchal and Hangul Ganchal of modern Korean Language time(16th century-19th century). Formal types can be divided based on whether Normal position or not, whether Omission or not, whether the Sending letter or not, whether the relationship of the high and the low or not. Normal position form and completion were made the first type which reveal well the typicality of the [Safety Expression]. Original position while [Own Safety] omitted as the second type, while Original position while [Opposite Safety] omitted as the third type, Original position while [Safety Expression] omitted as the fourth type. Inversion type were made as the fifth type which is the most severe solecism in [Safety Expression]. The first type is refers to Original position type that [Opposite Safety] precede the [Own Safety] and the completion type that is full of semantic element. This type can be referred to most typical and normative in that it equipped all components of [Safety Expression]. A second type is that [Safety Expression] is composed of only the [Opposite Safety]. This type is inferior to the first type in terms of set pattern, it is never outdone when it comes to the appearance frequency. Because asking [Opposite Safety] faithfully, omitting [Own Safety] dose not greatly deviate politeness and easy to write Ganchal, it is utilized. The third type is the Original position type showing the configuration of the [Opposite Safety]+Own Safety], but [Opposite Safety] is omitted. The fourth type is a Original position type showing configuration of the [Opposite Safety+Own Safety], but [Safety Expression] is omitted. This type is divided into A ; [Safety Expression] is entirely omitted and B ; such as 'saving trouble', the conventional expression, replace [Safety Expression]. The fifth type is inversion type that shown to structure of the [Own Safety+Opposite Safety], unlike the Original position type. This type is the most severe solecism type and real example is very rare. It is because let leading [Own Safety] and ask later [Opposite Safety] for face save is offend against common decency. In addition, it can be divided into the direct type that [Opposite Safety] and [Own Safety] is directly connected and indirect type that separate into the [story]. The semantic types of [Safety Expression] can be classified based on whether Sending letter or not, fast or slow, whether intimate or not, and isolation or not. For Sending letter, [Safety Expression] consists [Opposite Safety(Climate+Inquiry after health+Mental state)+Own safety(status+Inquiry after health+Mental state)]. At [Opposite safety], [Climate] could be subdivided as [Season] information and [Climate(weather)] information. Also, [Mental state] is divided as receiver's [Family Safety Mental state] and [Individual Safety Mental state]. In [Own Safety], [Status] is divided as receiver's traditional situation; [Recent condition] and receiver's ongoing situation; [Present condition]. [Inquiry after health] is also subdivided as receiver's [Family Safety] and [Individual Safety], [Safety] is as [Family Safety] and [Individual Safety]. Likewise, [Inquiry after health] or [Safety] is usually used as pairs, in dimension of [Family] and [Individual]. This phenomenon seems to have occurred from a big family system, which is defined as taking care of one's parents or grand parents. As for the Written Reply, [Safety Expression] consists [Opposite Safety (Reception+Inquiry after health+Mental state)+Own safety(status+Inquiry after health+Mental state)], and only in [Opposite safety], a difference in semantic structure happens with Sending letter. In [Opposite Safety], [Reception] is divided as [Letter] which is Ganchal that is directly received and [Message], which is news that is received indirectly from people. [Safety] is as [Family Safety] and [Individual Safety], [Mental state] also as [Family Safety Mental state] and [Individual Safety Mental state].