• Journal of Gastric Cancer
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• v.9 no.2
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• pp.57-62
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• 2009

Purpose: The use of automatic circular staplers for gastroduodenostomy after distal gastrectomy is now widely accepted. We compared the clinical outcomes of two different methods. Materials and Methods: Between March 2005 and February 2008, 134 patients with gastric cancer underwent distal gastrectomies. Seventy-six consecutive patients received end-to-side gastroduodenostomies (ES) between March 2005 and September 2006. The remaining 58 consecutive patients received end-to-end gastroduodenostomies (EE) between November 2006 and February 2008. We analyzed the surgical outcomes between the two groups (ES versus EE) on the basis of prospectively collected data. Results: Among the clinical factors, there were no differences between the two groups. The overall complication rates were 19.7% in the ES group and 13.8% in the EE group (P=0.489). With respect to anastomosis-related complications, 2 cases had bleeding and 2 cases had stenoses in the ES group, while 2 cases in the EE group had bleeding. Re-operation was needed in the case of intraluminal bleeding in the ES group. There were no mortalities in our study. Conclusion: The two methods for gastroduodenostomy were safe and technically feasible. Although there was no statistical difference in the overall complications, including anastomosis-related complications, we demonstrated better outcomes with respect to anastomotic stenosis in the EE group.

• Journal of Gastric Cancer
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• v.4 no.4
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• pp.230-234
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• 2004

Purpose: The use of laparoscopic surgery for gastric disease has been gaining popularity. However, there has been the controversy over the indications and the standard techniques of laparoscopic gastric surgery in the early gastric cancer (EGC). The purposes of this study were to compare the clinical outcomes among a hand-assisted laparoscopic distal gastrectomy (HALDG), a laparoscopy-assisted distal gastrectomy (LADG), and an open distal gastrectomy (ODG) and to discuss the role of these procedures in the treatment of EGC. Materials and Methods: Between August 2001 and July 2004, laparoscopic surgery was performed in our institution on 25 patients, LADG (n=7) and HALDG (n=18) with EGC. Analysis was performed on clinical data such as the operative time, the hospital stay, the start of oral intake, and the number of harvested lymph nodes. Patients were categorized into early and late groups by using the date of surgery and were also grouped by surgical procedure. To evaluate the feasibility and efficacy of laparoscopic surgery for EGC, we compared the clinical data with those for ODGs performed during the same period. Results: There was no difference in the number of harvested lymph nodes between the laparoscopic group and the open group, but the operation time in the laparoscopic group was longer than that in the open group (P<0.05). Also, no significant differences in other clinical data were found between the two groups. Comparing the early and the late periods of the series, the number of harvested lymph nodes for a HALDS increased from $22.31\pm4.29\;to\;29.40\pm3.21$ (P<0.05). Conclusion: Our early experience with laparoscopic gastric surgery shows that a wide range of possibilities exist for applying laparoscopic gastric surgery to selected gastric cancer patients. However, the surgical procedure should be standardized, and the outcomes of laparoscopic surgery, in comparison to those of open surgery, need to be confirmed based on a large randomized study. (J Korean Gastric Cancer Assoc 2004;4:230-234)

• Journal of the Korean earth science society
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• v.34 no.3
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• pp.224-234
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• 2013

This study examined a strong positive correlation between the North Atlantic Oscillation (NAO) index during June and the total tropical cyclone (TC) genesis frequency in the western North Pacific during July and August. To investigate a possible cause for this relationship, the mean difference between the highest positive NAO years and the lowest negative NAO years was analyzed by dividing into when the El Ni$\tilde{n}$o and La Ni$\tilde{n}$a years were included and when the El Ni$\tilde{n}$o and La Ni$\tilde{n}$a years were not included. When the El Ni$\tilde{n}$o and La Ni$\tilde{n}$a years were included, for the positive NAO years, the TCs mostly occurred in the northwestern region of tropical and subtropical western Pacific, and showed a pattern that migrate from the sea northeast of the Philippines, pass the East China Sea, and move toward the mid-latitudes of East Asia. In contrast, for the negative NAO years, the TCs mostly occurred in the southeastern region of tropical and subtropical western Pacific, and showed a pattern that migrate westward from the sea southeast of the Philippines, pass the South China Sea, and move toward the southern coast of China and Indochinese peninsula. These two different TC migration patterns affect the recurving location of TC, and for the positive NAO years, the recurving of TC was averagely found to take place in the further northeast. In addition, the migration patterns also affect the TC intensity, and the TCs of positive NAO years had stronger intensity than the TCs of negative NAO years as sufficient energy can be absorbed from the ocean while moving north in the mid-latitudes of East Asia. The TCs of negative NAO years showed weak intensity as they get weaken or disappear shortly while landing on the southern coast of China and the Indochinese peninsula. On the other hand, the above result of analysis is also similarly observed when the El Ni$\tilde{n}$o and La Ni$\tilde{n}$a years were not included.

• Tuberculosis and Respiratory Diseases
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• v.48 no.4
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• pp.471-477
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• 2000

Background : Coughing is the most common complaint for which patients seek medical service. When caughing continues over 3 weeks in non-smokers who do not take cough-provoking drugs, they are classified as patients with chronic cough. Three well known main causes of chronic caugh are postnasal drip syndrome, bronchial asthma and gastroesophaseal reflux disease. Among them, postnasal drip syndrome is reported to be the most common cause of all in chronic cough diseases, and allergic inflammation plays an important role in the pathogenesis of postnasal drip syndrome. CD23 and CD25 which are low affinity receptor for IgE and IL-2 receptor alpha, respectively, are closely related to allergic inflammation and their roles were evaluated in chronic cough patients. Methods : We evaluated 105 patients with chronic cough and selected 56 patients for measurement of serum CD23 & CD25 levels. We selected 10 normal, medical students for comparison of serum CD23 & CD25 levels. Result : The postnasal drip syndrome was found to be the most common cause of chronic cough. Serum CD23 and CD25 did not increase in chronic cough patient compared to normal controls. However in bronchial asthma patient, serum CD23 level was increased relative to normal control (p<0.05). Conclusion : In bronchial asthma presented as chronic cough, lymphocyte mediated allergic inflammation may related with the pathogenesis of the disease.

• Tuberculosis and Respiratory Diseases
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• v.46 no.4
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• pp.564-573
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• 1999

Background: With variable symptoms and nonspecific radiographic appearances, pulmonary embolism (PE) is a frequent and often undiagnosed cause of mortality and morbidity. The Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED) study suggested that the majority of patients undergoing ventilation-perfusion (V-Q) scan would require additional studies to establish or to exclude the diagnosis of PE. Pulmonary angiography has been regarded as gold standard for diagnosis of PE. However, it is an invasive procedure that may be associated with significant notable morbidity and mortality. Thus, availability of an accurate, noninvasive screening examination is highly desirable. Method: From October 1994 to February 1997, twenty patients (male 13, female 7, range 23-91 years, median 58 years) who were suspected as pulmonary embolism on the basis of clinical evidence and underwent the spiral volumetric computed tomography (spiral CT), were studied retrospectively to evaluate the effectiveness of spiral CT as a diagnostic tool in PE. Results: PE could be excluded with spiral CT in 4 patients ; diagnoses of these patients were lung cancer, pneumonia with lung abscess, bilateral pleural effusion due to congestive heart failure, nonspecific pulmonary abnormality retrospectively. One patient who disclosed high probability in V/Q scan, could be diagnosed as pneumonia with lung abscess and underlying emphysema with spiral CT. Among 4 patients who showed intermediate and low probability in V/Q scan, 3 patients could be confirmed as PE with spiral CT. Spiral CT was helpful in 3 patients, in whom V/Q scan could not be performed due to other reasons (e.g. night time, mechanical ventilation) to confirm the diagnosis of PE. Spiral CT could demonstrate embolus above lobar artery level in 11 patients, and up to segmental artery level in 5 patients. Conclusion: This study demonstrated that spiral CT could allow accurate demonstration of thrombotic clots in centrally localized embolism. Spiral CT could be effective, specific, noninvasive and useful diagnostic screening modality for the diagnosis of pulmonary embolism.

• Advances in pediatric surgery
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• v.8 no.2
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• pp.143-155
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• 2002

A survey on biliary atresia was made among 26 members of the Korean Association of Pediatric Surgeons. The members were required to complete a questionnaire and a case registration form for each patient during the twentyone-year period of 1980-2000. Three hundred and eighty patients were registered from 18 institutions. The average number of patients per surgeon was one to two every year. The male to female ratio was 1:1.3. The age of patients on diagnosis with biliary atresia was on average $65.4{\pm} 36.2$ days old. The national distribution was 32.8% in Seoul, 25.3% in Gyoungki-Do, 21.6% in Gyoungsang-Do, 9.27% in Choongchung-Do, etc. in order. The most common clinical presentation was jaundice (98.4%) and change of stool color (86.2%) was second. Two hundred eighty (74.7%) of 375 patients were operated by 80 days of age. Three hundred thirty six (9 1.9%) of 366 patients were operated on by the original Kasai procedure, and 305 (84.3%) of 362 patients were observed by bile-drainage postoperatively. The overall postoperative complication rate was 18.5% and the overall postoperative mortality rate was 6.8%. The associated anomalies were observed in 72 cases (22.5%). One hundred ninty five (64.7%) of 302 patients have been alive in follow-up and 49 (25.1%) have survived over 5 years without problem after operation. Ascending cholangitis, varices and ascites affected survival significantly, and the important long-term prognostic factor was the occurrence of complications.

• Journal of Soil and Groundwater Environment
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• v.11 no.1
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• pp.37-44
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• 2006

This study summarizes advantages and disadvantages of numerical methods and compares ELLAM and LEZOOMPC to develop an efficient numerical modeling technique on contaminant transport. Eulerian-Lagrangian method and Eulerian method are commonly used numerical techniques. However Eulerian-Lagrangian method does not conserve mass globally and fails to treat boundary in a straightforward manner. Also, Eulerian method has restrictions on the size of Courant number and mesh Peclet number because of time truncation error. ELLAM (Eulerian Lagrangian Localized Adjoint Method) which has been popularly used for past 10 years in numerical modeling, is known for overcoming these numerical problems of Eulerian-Lagrangian method and Eulerian method. However, this study investigates advantages and disadvantages of ELLAM and suggests a change for the better. To figure out the disadvantages of ELLAM, the results of ELLAM, LEZOOMPC (Lagrangian-Eulerian ZOOMing Peak and valley Capturing), and visual MODFLOW are compared for four examples having different mesh Peclet numbers. The result of ELLAM generates numerical oscillation at infinite of mesh Peclet number, but that of LEZOOMPC yields accurate simulations. The simulation results suggest that the numerical error of ELLAM could be alleviated by adopting some schemes in LEZOOMPC. In other words, the numerical model which combines ELLAM with backward particle tracking, forward particle tracking, adaptively local zooming, and peak/valley capturing of LEZOOMPC can be developed for not only overcoming the numerical error of ELLAM, but also keeping the numerical advantage of ELLAM.

• Korean Journal of Clinical Laboratory Science
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• v.50 no.1
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• pp.1-10
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• 2018

During early pregnancy, before the development of a functioning thyroid gland, thyroid stimulating hormone (TSH) is a very sensitive marker of thyroid dysfunction during pregnancy. Normal values have been modified during gestation with a downward shift. The fetus is influenced by the TSH supplied by the mother. TSH and free thyroxine (FT4) concentrations vary during pregnancy and conventional units can vary between laboratories. A downward shift of the TSH reference range occurs during pregnancy, with a decrease in both the lower and upper limits of maternal TSH, relative to the typical non-pregnant TSH reference range. Each laboratory produces its own reference TSH and FT4 concentrations because there are many different assays that yield different results in pregnancy. Therefore, automated immunoassays used for serum FT4 analysis are still used widely, but the important considerations discussed above must be noted. The use of population-based, trimester-specific reference ranges remains the best way to handle this issue The slight downward shift in the upper reference range of TSH occurring in the latter first trimester (7~12 weeks) of pregnancy, typically not observed prior to 7 weeks. Their use indicates high or low levels in a quantitative manner independent of the reference ranges. These data highlight the importance of calculating population-based pregnancy-specific thyroid parameter reference intervals. A precision medicine initiative in this area will require the collection and analysis of a large number of genetic, biological, psychosocial, and environmental variables in large cohorts of individuals. Large prospective randomized controlled trials will be needed to resolve these controversies.

• Journal of Chest Surgery
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• v.31 no.1
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• pp.32-39
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• 1998

High-dose aprotinin(Hammersmith regimen) has been widely used for years to control postoperative bleeding and reduce blood consumption in cardiac surgery but had known to cause some side-effects and had disadvantage in cost-effectiveness. The prospective controlled study of 33 patients undergoing cardiopulmonary bypass was performed to evaluate the efficacy for reducing postoperative bleeding and unfavorable effects of low-dose aprotinin. The level of hemoglobin and platelet in the blood and the amount of postoperative bleeding were assessed preoperatively, and postoperatively for the study of hemostatic function. The level of BUN and serum creatinine in the blood, levels of urine creatinine, total protein, albumin, alpha-1-microglobulin and creatinine clearance were assessed before and after the operation for the study of renal function. The aprotinin group had a significant reduction in chest tube drainage; 243$\pm$ 123 ml versus 406$\pm$303 ml(P=0.037) during 6 hours immediate-postoperatively, 494$\pm$358 ml versus 869$\pm$570 ml(P=0.045) during 24 hours postoperatively. The ratio of alpha-1-microglobulin/creatinine and microalbumin/creatinine in the urine were slightly increased in the aprotinin group postoperatively in comparison with the control group but there were no statistically significant difference(55$\pm$23 versus 24$\pm$10 in the alpha-1-microglobulin/creatinine, 56$\pm$19 versus 38$\pm$25 in the microalbumin/creatinine at post- operative 3rd day). There were no significant difference between two groups in other parameters of renal function, too. This study showed that low-dose aprotinin is an effective means of reducing postoperative bleeding without inducing significant renal dysfunction.

• Tuberculosis and Respiratory Diseases
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• v.57 no.1
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• pp.32-36
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• 2004

Background : The purpose of this study was to evaluate the usefulness of the pleural fluid carcinoembryonic antigen (CEA) and cytokeratin fragment 19 (CYFRA 21-1) tumor markers as complementary tools for the diagnosis of malignant pleural effusions. Patients and Methods : The levels of pleural and serum CEA and CYFRA 21-1 were prospectively assayed in 222 patients with pleural effusions (150 benign effusions, 57 bronchogenic carcinomas and 15 metastatic carcinomas). Results : The levels of pleural fluid CEA and CYFRA 21-1 in the malignant effusions were significantly higher than those in the benign effusions. With a specificity of 95%, the cut off values for the CEA and CYFRA 21-1 in pleural effusions were 5 and 89 ng/ml, respectively. The diagnostic sensitivities of the pleural fluid CEA and CYFRA 21-1 in malignant effusions were 72 and 54%, respectively, whereas using a combination of the two, the sensitivity increased to 87% (p<0.05). Conclusions : These findings suggest that a combination of the pleural fluid CEA and CYFRA 21-1 in pleural effusions can be useful in the diagnosis of malignant pleural effusions.