• Tuberculosis and Respiratory Diseases
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• v.42 no.1
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• pp.76-83
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• 1995

Background: Despite advances in chemotherapy, the treatment of inoperable non-small cell carcinoma of the lung remains poor. According to the recent reports, the response rates of mitomycin, vinblastine, and cisplatin(MVP) chemotherapy are higher than those of other cisplatin based polychemotherapy and MVP chemotherapy can be used as neoadjuvant chemotherapeutic regimen. But the overall response rates of MVP chemotherapy range from 17 to 53 percent, so we studied the effect of MVP chemotherapy in advanced non-small cell lung cancer. Method: We treated forty patients with stage III or IV non-small cell lung cancer with two courses of MVP chemotherapy($8mg/m^2$ of mitomycin on day 1, $6mg/m^2$ of vinblastine on day 2 & day 14, and $100mg/m^2$ of cisplastin on day 1) at 4 weeks interval. Then all patients were evaluated the response of chemotherapy 4 weeks later, and received further chemotherapy, palliative radiotherapy or supportive therapy according to the patient's condition. We also determined the median survival time and prognostic factors. Results: 1) Nine patients(23%) had a partial reponse, 23 patients(57%) had a stable disease, and disease progressed in 8 patients(20%). There were no patients with complete response. 2) The overall median survival time was 36 weeks(range, 9 to 119+ weeks). The median survival time of responder(partial response) and non-responder(stable and progressed) groups were 60 weeks(range, 36 to 82+ weeks) and 31 weeks(range, 9 to 119+ weeks) respectively(p=0.03). 3) The median survival time of the female group was 71 weeks and significantly prolonged in comparision with 35 weeks of the male group(p=0.01). But, the other prognostic factors didn't affect the survival time and response rate. 4) The median survival times of chemotherapy group and chemotherapy with palliative radiotherapy group were not significantly different. Conclusion: MVP combined chemotherapy is unsatisfactory in improving survival in advanced non-small cell lung cancer. Therefore, further studies are needed to find more active new agents and to estabilish the efficacy of the combined treatment with radiotherapy and/or surgery.

• Journal of Gastric Cancer
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• v.6 no.3
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• pp.167-172
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• 2006

Purpose: The laparoscopy assisted gastrectomy has been increasingly reported as the treatment of choice for early gastric cancer. However, expert surgeons, who have performed a conventional open gastrectomy for a long time, tend to have a negative attitude toward laparoscopic procedures. The aim of this study was to determine the learning curve of a laparoscopy assisted distal gastrectomy (LADG) for a surgeon expert in performing an open gastrectomy and to analyze the factors that have an effect on a LADG. Materials and Methods: Between April 2005 and March 2006, 62 patients underwent a LADG with D1+beta lymph-node dissection. The 62 patients were divided into 10 sequential groups with 6 cases in each group (the last group was 8 cases), and the time required to reach the plateau of the learning curve was determined by examining the average operative times of these 10 groups. Other factors, such as sex, BMI, complications, transfusion requirements, the number of retrieved lymph nodes, and change of postoperative hemoglobin level, were also analyzed. Results: With the $5^{th}$ group (after 30 cases), the operative time reached a plateau (average: 170 min/operation). The differences between before the $30^{th}$ case and after the $31^{st}$ case with respect to changes in the postoperative hemoglobin level, the number of retrieved lymph nodes, the transfusion requirements, and the complications rate were not significant. Conclusion: According to an analysis of the operative time, experience with 30 LADGs in patients with early gastric cancer is the point at which the plateau of the learning curve (7 months) is reached. Abundant experience with a conventional open gastrectomy and a well-organized laparoscopic surgery team are important factors in overcoming the learning curie earlier.

• Journal of Gastric Cancer
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• v.8 no.1
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• pp.27-34
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• 2008

Purpose: Many recent studies have reported on the feasibility and usefulness of laparoscopy assisted distal gastrectomy (LADG) for treating early gastric cancer. On the other hand, there has been few reports about laparoscopy assisted total gastrectomy (LATG) because upper located gastric cancer is relatively rare and the surgical technique is more difficult than that for LADG, We now present our procedure and results of performing LATG for the gastric cancer located in the upper or middle portion of the stomach. Materials and Methods: From Jan 2005 to Sep 2007, 96 patients underwent LATG by four surgeons at the Asan Medical Center, Seoul, Korea. Among them, 48 consecutive patients who were operated on by asingle surgeon were analyzed with respect to the clinicopathological features, the surgical results and the postoperative courses with using the prospectively collected laparoscopy surgery data. Results: There was no conversion to open surgery during LATG. For all the reconstructions, Roux-en Y esophago-jejunostomy and D1+beta lymphadenectomy were the standard procedures. The mean operation time was $212{\pm}67$ minutes. The mean total number of retrieved lymph nodes was $28.9{\pm}10.54$ (range: $12{\sim}64$) and all the patients had a clear proximal resection margin in their final pathologic reports. The mean time to passing gas, first oral feeding and discharge from the hospital was 2.98, 3.67 and 7.08 days, respectively. There were 5 surgical complications and 2 non-surgical complications for 5 (10.4%) patients, and there was no mortality. None of the patients needed operation because of complications and they recovered with conservative treatments. The mean operation time remained constant after 20 cases and so a learning curve was present. The morbidity rate was not different between the two periods, but the postoperative course was significantly better after the learning curve. Analysis of the factors contributing to the postoperative morbidity, with using logistic regression analysis, showed that the 8MI is the only contributing factor forpostoperative complications (P=0.029, HR=2.513, 95% CI=1.097-5.755). Conclusions: LATG with regional lymph node dissection for upper and middle early gastric cancer is considered to be a safe, feasible method that showed an excellent postoperative course and acceptable morbidity. BMI should be considered in the patient selection at the beginning period because of the impact of the BMI on the postoperative morbidity.

• Journal of the Korea Concrete Institute
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• v.26 no.5
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• pp.651-660
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• 2014

Structural members using ultra high strength concrete which usually used with steel fiber is designed with guidelines based on several investigation of SF-RPC(steel fiber reinforced reactive powder concrete). However, there are not clear design method yet. Especially, SF-RPC member should be casted with steam(90 degree delicious) and members with SF-RPC usually used with precast members. Although the most important design parameter is development method between SF-RPC and steel reinforcement(rebar), there are no clear design method in the SF-RPC member design guidelines. There are many controversial problems on safety and economy. Therefore, in order to make design more optimum safe design, in this study, we investigated bond stress between steel rebar and SF-RPC according to test. Test results were compared with previously suggested analysis method. Test was carried out with direct pull out test using variables of compressive strength of concrete, concrete cover and inclusion ratio of steel fiber. According to test results, bond stress between steel rebar and SF-RPC increased with increase of compressive strength of concrete and concrete cover. Increasing rate of bond stress were decrease with increase of compressive strength of SF-RPC and concrete cover significantly. 1% volume fraction inclusion of steel fiber increase the bond stress between steel rebar and SF-RPC with two times but 2% volume fraction cannot affect the bond stress significantly. There are no exact or empirical equations for evaluation of SF-RPC bond stress. In order to make safe bond design of SF-RPC precast members, previously suggested analysis method for bond stress by Tepfers were evaluated. This method have shown good agreement with test results, especially for steel fiber reinforced RPC.

• Journal of Aquaculture
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• v.21 no.2
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• pp.82-88
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• 2008

A 12-week feeding trial was conducted to investigate the effects of dietary supplementation of probiotics as a feed additive for juvenile Korean rockfish Sebastes schlegeli. Four experimental diets supplemented with no probiotic(Control), Bacillus polyfermenticus(BP), Bacillus licheniformis(BL) or Bacillus polyfermenticus plus Saccharomyces cerevisiae(BP+SC) at $1.0{\times}10^7$ CFU/kg diet as a dry-mater(DM) basis were prepared by mixing with a basal diet. After 12 weeks of the feeding trial, fish fed BP+SC diet showed significantly higher weight gain(WG), feed efficiency(FE), specific growth rate(SGR) and protein efficiency ratio(PER) than those of fish fed control diet(P<0.05), however there were no significant differences in WG, FE, SGR and PER among fish fed the BP, BL and BP+SC diets. Fish fed BP and BP+SC diets showed significantly higher condition factor(CF) than that of fish fed control and BL diets. Fish fed BP, BL, BP+SC diets showed significantly higher hepatosomatic index(HSI) than that of fish fed control diet, however there was no significant difference in HSI among fish fed BP, BL and BP+SC diets. Fish fed BP+SC diet showed significantly lower serum glucose than that of fish fed control diet, however there was no significant difference in serum glucose among fish fed BP, BL and BP+SC diets. Fish fed BP+SC diet showed significantly higher respiratory burst activity(NBT assay) than that of the fish fed control and BL diets, however there was no significant difference in NBT assay between fish fed BP and BP+SC diets. Fish fed BP and BL diets showed significantly higher lysozyme activity than that of the fish fed control diet, however there was no significant difference in lysozyme activity among fish fed BP, BL and BP+SC diets. Fish fed BP and BP+SC diets showed significantly lower cumulative mortality than that of the fish fed control diet, however there was no significant difference in cumulative mortality among fish fed BP, BL and BP+SC diets after the challenge test. From these results, dietary B. polyfermenticus, B. licheniformis and B. polyfermenticus plus S. cerevisiae supplementation in juvenile Korean rockfish diet could enhance growth performances, non-speicific immunities and a higher resistance against the specific pathogen.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.3
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• pp.381-390
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• 2004

The purpose of this in vitro study was to investigate the effects of Nd:YAG laser irradiation and fluorides on acid drink demineralized enamel. The materials were 30 freshly extracted permanent premolars with intact smooth enamel surfaces. They were demineralized with Coca-cola at $37^{\circ}C$ for 12hours and then irradiated by Nd:YAG laser with 6W power, $50mJ/cm^2$ energy density, and 20Hz pulse repetition. After laser irradiation, teeth were treated by three kinds of fluorides; (1)0.05% NaF fluoride solution (2)1.23% APF gel and (3)0.1%F fluoride varnish, microhardness(VHN) and Diagnodent scores were measured and the surfaces of each treated specimens were also observed with SEM under 1500 magnification. The results were as follows: 1. In the change of microhardness(VHN), it decreased to 34.68% from the initial micrhardness, increased to 78.37% after laser irradiation and increased to 82.62% after fluoride treatment, there were significant differences except when it was irradiated and treated with fluoride(P<0.05). 2. In the change of Diagnodent scores, it was decreased to 28.08% from the initial scores after demineralization, and then increased to 59.81% after laser irradiation, and increased to 82.17% after fluoride treatment. Scores were different significantly between the scores of initial, demineralization, laser irradiation and fluoride treatment(P<0.05). All the scores were not different significantly between fluoride types. 3. SEM observation showed that the lased enamel surfaces after demineralization were thermally degenerated and showed molten lava-like appearance and crater with cracks and many microholes.

• Tuberculosis and Respiratory Diseases
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• v.51 no.4
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• pp.334-345
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• 2001

Background : Pulmonary tuberculosis(TB) is still prevalent and remains a significant clinical problem for the elderly. However, the disease presents in many ways, and there are frequent adverse drug reactions that may prevent the early diagnosis and treatment of elderly TB patients compared to the young. The purpose of this study was to determine whether or not there are any differences in the clinical feature of pulmonary tuberculosis(TB) in both the diagnosis and treatment between the young (less than 64 years) and the elderly (65 years and more). Methods : The medical records of 125 young and 70 elderly pulmonary TB patients, who were diagnosed with and treated for pulmonary TB at the Seoul Municipal Boramae Hospital from November 1991 to January 1997, were analyzed retrospectively. Results : Anorexia(12% vs. 31.4%), general weakness (20.0% vs. 54.3%), dyspnea(21.6% vs. 37.1%) and an abnormal mentality (0.8% vs. 15.7%) were more frequent presenting symptoms in elderly TB patients, whereas hemoptysis (32.8% vs. 10.0%) and fever (BT > $37^{\circ}C$, 58.4% vs. 35.7%) were more frequent in the young. The elderly had a higher number of cardiovascular and chronic obstructive pulmonary diseases as underlying illnesses. In chest PA, there were no differences in the location of the TB lesion, but the appearances were initially diagnosed more frequently as pneumonia or lung cancer (8.8% vs. 30.0%, p<0.05) in the elderly. There was no difference in the detection rate of acid fast bacilli(AFB) in the sputum between the two groups. There were no differences in the treatment response and follow-up loss. However, adverse drug reactions (13.6% vs. 45.7%, p<0.05), and changes in medication (4.9% vs. 25.7%, p<0.05) during treatment occurred more frequently in the elderly. One among the 125 young patients died from tuberculosis whereas 6 among the 70 elderly patients died from the disease. Conclusion : Because the clinical and radiological presentations were more atypical, a sputum AFB smear and culture should be done immediately in the elderly who are TB. The elderly experienced more frequent adverse drug reactions and mortality during treatment, but the response to treatment was good and rapid.

• Tuberculosis and Respiratory Diseases
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• v.52 no.4
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• pp.395-404
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• 2002

Background : Surfactant protein A (SP-A) is important for regulating surfactant secretion, synthesis and recycling. However, It's regulation in vivo is unclear. SP-A has important roles in regulating surfactant metabolism as well as determining its physical properties. Glucocorticoid accelerates the morphologic differentiation of epithelial cells into type II cells and increase the rate of phosphatidylcholine synthesis. Methods : The authors investigated the effects of glucocorticoid on the accumulation of mRNA encoding SP-A and SP-A protein content. Adult rats were given various doses of subcutaneous dexamethasone and sacrificed after 24 hours and one week. SP-A mRNA was measured using a filter hybridization method. The lung SP-A protein content was determined using a double sandwich ELISA assay with polyclonal antiserum raised in rabbits against purified rat SP-A. Results : 1) The accumulation of SP-A mRNA in the dexamethasone treated group 24 hours after 0.2 mg/kg dexamethasone treatment was increased 38.8% compared to the control group. 2) The accumulation of SP-A mRNA in the dexamethasone treated group 1 week after 2 mg/kg dexamethasone treatment was 49.7% higher than the control group(P<0.01). 3) The total lung SP-A level was not altered after 24 hours by the 0.2mg/kg treatment. The total lung SP-A content one week after 2mg/kg dexamethasone administration was 373.7% higher than the control group(P<0.005). Conclusion : Dexamethasone treatment results in an increase in the SP-A mRNA and SP-A protein levels, suggesting that the pretranslational events in vivo may in part contribute to this process.

• Clinical and Experimental Pediatrics
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• v.49 no.3
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• pp.278-286
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• 2006

Purpose : Although suprapubic bladder aspiration(SBA) is the most reliable technique for identifying bacteriuria in young infant, no report has been published about the clinical manifestations of urinary tract infection(UTI) diagnosed by aspirated urine in Korea. This study was performed to examine clinical manifestations and related factors of UTI confirmed by a positive urine culture obtained by SBA in young infants. Methods : We reviewed medical records of 159 infants younger than six months of age, who had been admitted for UTI to Korea University Ansan Hospital from January 2002 to June 2005. Results : The male:female ratio was 5.1 : 1. The most common pathogen in urine culture was Escherichia coli(92.5 percent). Most of the gram-negative pathogens had high sensitivity to amikacin, or third generation cephalosporins and had low sensitivity to ampicillin, trimethoprim-sulfamethoxazole, or gentamicin. Hydronephrosis and vesicoureteral reflux(VUR) were present in 32.7 percent and 27.7 percent respectively. Renal cortical defects observed on DMSA scans were detected in 37.1 percent. Prolonged fever duration and hospital day, high erythrocyte sedimentation rate(ESR) and C-reactive protein(CRP) levels, hydronephrosis and VUR were related to the renal cortical defects(P<0.05). Rates of UTI-associated bacteremia and aseptic meningitis were 8.3 percent and 6.6 percent. Conclusion : Early differential diagnosis is very important in infants younger than 6 months of age with UTI because the clinical findings are non-specific and UTI-associated bacteremia and aseptic meningitis are concomitantly found. Because prolonged fever and higher ESR and CRP levels are risk factors of the renal cortical defects, radiologic evaluations and nephrologic follow-up were needed in identifying the predisposing congenital abnormalities and chronic renal scarring.

• Clinical and Experimental Pediatrics
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• v.45 no.8
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• pp.961-966
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• 2002

Purpose : We compared the underlying or associated diseases according to the frequency of platelet transfusions in neonates with thrombocytopenia to know the factors predicting which patients will require multiple platelet transfusions. We also compared mortality. Methods : A retrospective study was performed in 72 neonates who received the platelet transfusions in neonatal intensive care unit(NICU) between August 1996 and July 2001. Group I received one platelet transfusion and group II received two or more. We compared the frequency of underlying or assodiated diseases such as sepsis/disseminated intravascular coagulopathy(DIC), respiratory distress syndrome(RDS), intraventricular hemorrhage(IVH), patent ductus arteriosus (PDA), necrotizing enterocolitis(NEC), liver or renal disease, and mortality between two groups. Results : Of the 72 patients, 29(40.2%) received one and 43(59.7%) received two or more transfusions; 16(22.2%) received four or more. There were no statistically significant differences in gestational age, birth weight, sex, and maternal history between two groups. C-section rate was higher in group II(20.7% vs. 55.8%, P<0.05) and the incidence of PDA was higher in group I (55.2% vs. 30.2%, P<0.05). Otherwise, there were no statistically significant differences in the incidence of sepsis/DIC, RDS, IVH, RDS, CLD, NEC, liver or renal disease, pulmonary hemorrhage and hypoxic ischemic encephalopathy, and mortality between group I and group II. Conclusion : There was no significant difference in clinical morbidity and mortality according to the frequency of platelet transfusion in neonates with thrombocytopenia. Further study is needed to know the predicting factor for multiple platelet transfusions in neonates with thrombocytopenia.