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Assessment of the Quality of Esophago-gastric Anastomosis by Endoscopic Examination -Cervical Versus Intrathoracic Anastomosis- (내시경을 통한 식도-위 문합술의 질 평가-경부와 흉부 문합의 비교-)

  • Shim, Jae-Hoon;Kim, Hyun-Koo;Baek, Man-Jong;Kim, Hark-Jei;Choi, Young-Ho
    • Journal of Chest Surgery
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    • v.39 no.12 s.269
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    • pp.920-926
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    • 2006
  • Background: Mortality and morbidity of anastomotic complications after esophagectomy have gradually decreased in recent years. However, swallowing difficulties and reflux symptoms after esophagogastrostomy continue to be a burden jeopardizing the quality of life. In the present study, we evaluated the quality of esophagogastrostomy by analyzing anastomotic stenosis and reflux esophagitis. Material and Method: A retrospective analysis was made in 74 patients who underwent esophagogastrostomy after esophagectomy by one surgeon between January 1995 and December 2004. 53 patients of them received endoscopic examination during follow-up($29{\pm}23.6$ months, range $5{\sim}111$ months). Reflux esophagitis and stenosis at anastomostic site were analyzed according to the techniques and locations of esophagogastrostomy. Result: The median age at the time of repair was $60.3{\pm}8.87$ years(range $39{\sim}81$ years). 23 patients received a hand-sewn esophagogastric anastomosis and 30 patients a circular stapled one. There was no significant statistical difference in terms of anastomotic stenosis(p=0.64) and reflux esophagitis(p=0.41) between the two groups. Cervical anastomosis was peformed in 26 patients and intrathoracic anastomosis in 27 patients. No significant statistical difference in anastomotic stenosis between the two groups was found(p=0.44), but reflux esophagitis was noted in 3 patients in the cervical anastomosis group and 14 patients in the intrathoracic anastomosis group(p=0.003). Conclusion: Cervical anastomosis was supposed to have a better quality of esophagogastrostomy by lowering the risk of reflux esophagitis. In the future, the comprehensive study including a patient's subjective symptom and Barrett's metaplasia should be performed in larger cases.

Fine Structure of Mature Sperms of Cephalopods (Octopus minor, Octopus ocellatus and Todarodes pacificus) Inhabiting the Korean Waters II (한국 연근해산 두족류 (Octopus minor, Octopus ocellatus and Todarodes pacificus) 성숙정자의 미세구조 II)

  • Kim, Sang-Won;Chang, Nam-Sub
    • Applied Microscopy
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    • v.31 no.4
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    • pp.333-345
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    • 2001
  • The mature sperms of three species of cephalopods (Octopus minar, Octopus ocellatus, Todarodes pacificus) were observed by electron microscopy. The results obtained are as follows: The sperm lengths of Octopus minor and Octopus ocellatus of octopods are long and they are about $390{\mu}m$ and $125\sim130{\mu}m$, respectively, but the sperm length of Todarodes pacificus is short and about $35{\mu}m$. The sperm of Octopus minor has a helical acrosome and a head bent a little like a banana while Octopus ocellatus of octopod has a twisted acrosome and a long rod-shaped head. A number of horizontal stripes are observed as a periodic structure in their subacrosome cavities and dense plugs are formed in the cavities of their heads. On the other hand, the acrosome of Todarodes pacificus is circular cap-shaped, and its head is long and oval. It is notable that two small cavities were observed in its basal acrosome. Juxtanuclear acrosomal materials of high electron density filled the subacrosomal cavity. In the middle piece of mature sperms of Octopus minor and Octopus ocellatus, the mitochondria form the mitochondrial sleeve, but the numbers of mitochondria differ between the species so that they are $11\sim12$ and $8\sim9$, respectively. Meanwhile, in the middle piece of mature sperms of Todarodes pacificus, the mitochondria are separated from the axoneme, forming a mitochondrial spur in which $10\sim13$ mitochondria and some electron dense materials concentrate. The axoneme of Octopus minor, Octopus ocellatus and Todarodes pacificus are of 9+2 type in common, surrounded by 9 coarse fibres. A number of glycogen were observed only in the axoneme of Todarodes pacificus. The coarse fibres were found as far as the main piece of sperm tail in Octopks minor and Todarodes pacificus, while to the end piece of sperm tail in Octopus ocellatus.

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Relation of Ethanol and Calcium to Contractile and Electrical Activity of Cat Stomach (고양이 위(胃)의 수축 및 전기활동에 대한 에탄올과 칼슘의 관계)

  • Kim, Myung-Suk;Sim, Sang-Soo;Yoon, Shin-Hee;Han, Sang-Jun;Kim, Chung-Chin;Choi, Hyun
    • The Korean Journal of Physiology
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    • v.21 no.2
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    • pp.259-272
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    • 1987
  • This was study carried out to investigate the effect of calcium on spontaneous contraction and electrical activity induced by ethanol in gastric smooth muscle. After peeling off the mucous membrane from the isolated whole stomach of 102 cats, two kinds of small muscle preparations $(2.0{\times}0.2\;cm)$, one longitudinal and the other circular, were excised from the fundus, the corpus and the antrum portion of each whole stomach specimen. The isometric contraction of the small muscle preparation was measured in a cylinder-shaped chamber filled with Krebs-Ringer-dextrose solution (pH 7.4, temperature $36{\pm}0.5^{\circ}C$) bubbling with 5% $CO_2$ in $O_2$. A large muscle preparation $(5.0{\times}1.2\;cm)$ was excised from the anterior wall of the corpus-antrum portion of the same specimen in 72 of 102 cats. The gastric electrical activity (slow wave and spike potential) was monopolarly recorded by four capillary electrodes (Ag-AgCl), of which two were placed on the corpus and two on the antrum, in a muscle chamber filled with the same solution as described above. Changes in the amplitude of the contraction, frequency of the gastric slow wave and the production of the spike potential were observed after adding ethanol and/or under the treatments with verapamil, $CaCl_2$ and Ca-free Krebs-Ringer-dextrose solution. The results were as follows: 1) After adding ethanol, the spontaneous phasic contraction of the corpus was reduced dose-dependently (0.125-2.0%), which was totally abolished by higher concentrations (2.0-8.0%) of ethanol. 2) The corporal phasic contraction was also completely abolished by verapamil $(3{\times}10^{-5}\;M)$ or Ca-free Krebs-Ringer-dextrose solution. The contraction was increased by $CaCl_2\;(1.8{\times}10^{-3}\;M)$, but the inhibitory effect of ethanol on the contraction persisted even under the treatment with $CaCl_2$. 3) At higher concentrations, ethanol caused tonic contraction of both preparations from the fundus, the corpus and the antrum in a dose-dependent manner. The tonic contraction of the fundus produced by ethanol was not influenced by $CaCl_2$ or verapamil, whereas the tonic contraction was not produced by ethanol in tile Ca-free solution. 4) Frequency of gastric slow wave was decreased dose-dependently by the addition of ethanol (0.25-1.0%), and tile slow wave was not produced by higher concentration of ethanol (2.0%). 5) The frequency of slow wave was significantly reduced by verapamil only and the inhibitory influence of ethanol on the slow wave frequency was reinforced by verapamil. 6) The treatment of $CaCl_2$ increased significantly the slow wave frequency, and attenuated the inhibitory effect of ethanol on the frequency. It is therefore suggested that ethanol regulates the phasic contraction and the production of slow wave by interfering with the transport of calcium in the stomach muscle of the cat.

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Geographic Conditions and Garden Designs of Byeol-seo Scenic Site of Gimcheon Bangcho-Pavilion and Mrs Choi's Pond (별서 명승 김천 방초정(芳草亭)과 최씨담(崔氏潭)의 입지 및 조영 특성)

  • Rho, Jae-Hyun;Lee, Hyun-Woo
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.34 no.1
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    • pp.71-82
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    • 2016
  • Through literature review and on-site survey of Gimcheon Bangcho pavilion(芳草亭), the features of garden design(庭園意匠) including geographic conditions, landscape modeling of Nujeong(樓亭) and Jidang(池塘, Pond), and scenic interpretations in Nujeong Jeiyoung poetry(樓亭題詠詩) have been carefully researched and the findings are presented below. Bangcho pavilion is located in a village called Wonteomaeul, which belongs to the feng shui state of golden hairpin and floating lotus. It has long been the cultural hub of communication and social interactions among the villagers. The Head House of Jeongyanggong(靖襄公宗宅), the main house(本第) of the Yeonan Yi Clan(延安李氏), is about 150m away from Bangcho pavilion, an artistic space whose landscape modeling is of the form called Nujeong. The name 'Bangcho' reflects the noble man(君子)'s determination: "I yearn for the place where honey parrots fly and the fragrant grass grow." From the two story structure of the pavilion where there is an additional floor installed to the central ondol room by a four-sided subdivision door, one can detect the aspiration of the men for pursuing an open view. One can also observe the efforts in designing the room to be used for multiple purposes from a private place to an office for periodic publication of a family lineage document called "Garyejunghae(家禮增解)". Bangcho pavilion's main sight of interest is Mrs Choi's Pond(崔氏潭), the one and only garden structure that comprises the twin round island of square pond(方池雙圓島) among the existing Jidangs in Korea. In this special Jidang, there are two coexisting islands that represent a well thought out garden facility for symbolizing conjugal affection and unyielding fidelity between master and servent(主從). In addition, the three inflows and one outflow facing the Ramcheon valley is regarded as an ideal garden design optimized for performing the function of a village bangjuk which is the site for undercurrent creation and ecological reprocessing. At present, Giant pussy willow is the only circular vegetation identified in the area of Bangcho pavilion, although this plant species is about to wither away judging from the signs of decrepitude that seems to persist for two out of three weeks. The old pine tree that appears in the 1872 Jeiyoung poetry of Byeongseon Song(宋秉璿) no longer exists. Anjae(安齋) Jang Yoo(張瑠)'s "Eight Scenary on Bangcho pavilion(芳草亭八詠)" and its expansive reproduction "Ten Scenary on Bangcho pavilion(芳草亭十景)" from Gwagang(守岡) Lee Manyoung(李晩永) depict vividly the pastoric scenery of an idyll(田園景) that stretches throughout the natural and cultural landscape of the province of Gimcheon and Guseong surrounding the Bangcho pavilion. The Bangcho pavilion sutra aims to establish Bangcho pavilion and the village of Wonteomaeul as the centre of microcosmos by dividing and allocating its scenic features according to the four seasons and times(四季四時), the eight courses(八方) and the meteorological phenomena, and it is the incarnation(顯現) of landscape perception upon the Byeol-seo Scenic site of Bangcho pavilion, the cultural hub of the region.

Effects of Electrolytes and Drugs on the Inhibitory Junction Potentials Recorded from the Antrum of Guinea-pig Stomach (기니피그 유문동에서 기록되는 억제성 접합부 전압에 미치는 전해질과 약물의 효과)

  • Goo, Yong-Sook;Suh, Suk-Hyo;Lee, Suk-Ho;Hwang, Sang-Ik;Kim, Ki-Whan
    • The Korean Journal of Physiology
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    • v.24 no.1
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    • pp.1-13
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    • 1990
  • The effects of electrolytes, adenosine, ATP, 5-hydroxytryptamine (5-HT, serotonin) and ketanserin on the inhibitory junction potentials (IJPs) were investigated to clarify the interactions of these drugs with the neurotransmitters released from non-adrenergic, non-cholinergic nerves in the antrum of guinea-pig stomach. Electrical responses of antral circular muscle cells were recorded intracellularly using glass capillary microelectrode filled with 3 M KCI. All experiments were performed in Tris-buffered Tyrode soluition which was aerated with 100% $O_{2}$ and kept at $35^{\circ}C$. The results obtained were as follows: 1) Inhibitory junction potential (IJP) was recorded in antral strip, while excitatory junction potential (EJP) was recorded in fundic strip. 2) IJP recorded in antral strip was not influenced by atropine $(10^{-6}\;M)$ and guanethidine $(5{\times}10^{-6})$. 3) The amplitude of IJP increased in high $Ca^{2+}$ solution, while that of IJP decreased in high $Mg^{2+}$ solution or by $Ca^{2+}$ antagonist (verapamil). Apamin, $Ca^{2+}$-activated $K^{+}$ channel blocker blocked IJP completely. 4) ATP and adenosine decreased the amplitude of IJP. 5) 5-HT decreased the amplitude of IJP with no change of the amplitude of slow waves, while ketanserin (5-HT type 2 blocker) decreased the amplitude of slow waves markedly with no change in that of IJP. From the above results, the following conclusions could be made. 1) IJP recorded in antral strip is resulted from neurotransmitters released from non-adrenergic, non-cholinergic nerves. 2) An increase in the concentration of external $Ca^{2+}$ enhances the release of neurotransmitters from non-adrenergic, non-cholinergic nerves which activate the $Ca^{2+}$-dependent $K^{+}$ channel.

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Laparoscopic Assisted Total Gastrectomy (LATG) with Extracorporeal Anastomosis and using Circular Stapler for Middle or Upper Early Gastric Carcinoma: Reviews of Single Surgeon's Experience of 48 Consecutive Patients (원형 자동문합기를 이용한 체외문합을 시행한 복강경 보조 위전절제술: 한 술자에 의한 연속적인 48명 환자의 수술성적분석)

  • Cheong, Oh;Kim, Byung-Sik;Yook, Jeong-Hwan;Oh, Sung-Tae;Lim, Jeong-Taek;Kim, Kab-Jung;Choi, Ji-Eun;Park, Gun-Chun
    • 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.

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Behavior of Juvenile Black Sea Bass, Centropristis striata (Linnaeus) on Oyster Reefs (Oyster reef에서 black sea bass, Centropristis striata 치어의 행동)

  • Gwak, Woo-Seok
    • Korean Journal of Ichthyology
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    • v.20 no.3
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    • pp.173-178
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    • 2008
  • The substrate preferences of juvenile black sea bass Centropristis striata (Linnaeus) was tested in a circular tank (1.5 m diameter${\times}$0.4 m deep) divided into two equal areas of oyster-related (oyster reef and whole oyster shell) and sand substrates. All trials were video taped for 20 min. Tapes were viewed on a monitor and locations of all fish recorded and timed with respect to substrate. $Mean{\pm}SE$ times on oyster shell were $18.1{\pm}2.0min$ (1-fish trial-1) and $17.5{\pm}1.7min$ (5-fish trial-1). $Mean{\pm}SE$ times on sand were $2.0{\pm}1.0min$ (1-fish trial-1) and $2.5{\pm}1.7min$ (5-fish trial-1). Black sea bass juveniles showed a significant preference for oyster reef and shell over sand substrate in single-fish trials (paired t-test, P<0.05) and also in five-fish trials (paired t-test, P<0.05). $Mean{\pm}SE$ times under oyster reefs were $16.6{\pm}2.0min$ in single-fish trials and $10.7{\pm}2.3min$ in five-fish trials. Mean numbers of movements among oyster reefs were $1.1{\pm}1.0$ in single-fish trials and $11.5{\pm}3.1$ in fivefish trials. Fish spent significantly less time under oyster reefs in five-fish trials, compared to single-fish trials (paired t-test, P<0.05) and they moved more frequently in five-fish trials than in single-fish trials (paired t-test, P<0.05). Significantly higher competition for a refuge in five-fish trials may induce less time under oyster reefs as well as frequent movement of black sea bass juveniles on shell substrate.

Development of Extruded Pellet for Growth of Flounder (Paralichthys olivaceus) in Commercial Scale Feeding Trials (넙치 육성용 배합사료 개발을 위한 현장 사육 실험)

  • Seo, Joo-Young;Choi, Jin;Lee, Jong-Ha;Lee, Sang-Min
    • Journal of Aquaculture
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    • v.20 no.2
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    • pp.114-120
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    • 2007
  • Two feeding experiments were conducted to evaluate the effects of the experimental extruded pellet (EP), commercial EP and raw fish-based moist pellet (MP) on growth of growing flounder (Paralichthys olivaceus). In experiment 1, two replicate groups of the fish (average body weight of $115{\pm}3.2\;g$) were fed one of five experimental diets (EP1-EP5) and MP in circular concrete tanks (4.6 m $\phi$, 0.6 m depth) for 78 days. In experiment 2, in order to evaluate EP in the commercial scale ($8\;m\;{\times}\;8\;m$), flounder (average body weight of $137{\pm}11.4\;g$) were fed one of five EPs (EP1-EP5) used in experiment 1, commercial EP (EP6) and two MEPs (MEP4 and MEP6) as moist pellet types which were made from EP4 and EP6, respectively, by being sprayed with a mixture of water and additives for 80 days. In experiment 1, weight gain of fish fed the all EPs was not significantly different from that of MP. Feed efficiency of fish fed the EP4 was highest, and protein efficiency ratio of fish fed the EP4 and EP5 was significantly higher than that of fish fed the MP (P<0.05). Significant differences were observed in the contents of moisture and crude lipid in the muscle, and moisture in the liver of fish (P<0.05). In experiment 2, weight gain of fish fed the EP4 and MEP4 were highest and feed efficiency showed high tendency in EP4, MEP4 and MEP6. Fish fed the MEP6 showed higher weight gain and feed efficiency compared to those of fish fed the EP6, but there was no difference in those of fish fed EP4 and MEP4. Based on the results of this study, dietary formulations used in EPs could be most recommendable applied in the practical extruded pellet feeds for flounder grown from 114 g to 350 g.

A Three-dimensional Photoelastic Analysis of Stress Distributions Around Osseointegrated Implants and Abutment Teeth According to Bridge Connecting Type (골유착성(骨癒着性) 임플란트와 치아간(齒牙間)의 보철물(補綴物) 연결(連結) 형태(形態)에 따른 주위(周圍) 골조직(骨組織)의 응력분산(應力分散)에 관한 3차원적(次元的) 광탄성(光彈成) 분석(分析))

  • Lee, Moo-Geon;Cho, Sung-Am
    • The Journal of Korean Academy of Prosthodontics
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    • v.32 no.1
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    • pp.120-147
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    • 1994
  • This study was performed for the purpose of evaluating the stress distribution around threaded type implants, cylindrical type implants and teeth connected with rigid or non-rigid connector. The stress distribution around the surrounding bone was analyzed by three-dimensional photoelastic method. Twelve mandibular photoelastic epoxy resin models and a circular polariscope were used to record the isochromatic fringes. After the stress distribution around the implant and tooth was observed, the results were as follows ; 1. In threaded type implants, stress concentrated patterns were observed at the neck either vertical or 25 degree lateral force. 2. The stress concentrated patterns were observed at the tooth apical portion and neck portions of the implant and tooth when a threaded implant was connected with the tooth by either a rigid or non-rigid connector. More force was generated at the tooth neck portion by a rigid connector and more force at the implant neck portion by a non-rigid connector. 3. The stress concentrated patterns were observed at the apical portion of the implant and tooth when a cylindrical type ,implant was connected with the tooth either by a rigid or non-rigid connector. More force was generated at the tooth apical portion by a rigid connector and more force at the neck portion of the tooth and implant by a non-rigid connector. 4. The stress around the tooth was more equally distributed in a threaded type implant than in a cylindrical implant when the tooth was connected with either a rigid or non-rigid connector. 5. The stress around a threaded type implant was progressively more equally distributed in the following order : 1) when used a single implant, 2) a non-rigid connection with the implant and tooth, 3) a rigid connection with the implant and tooth, 4) a rigid connection with two implant fixtures.

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Study on the Physical Properties of the Gamma Beam-Irradiated Teflon-FEP and PET Film (Teflon-FEP 와 PET Film 의 감마선 조사에 따른 물리적 특성에 관한 연구)

  • 김성훈;김영진;이명자;전하정;이병용
    • Progress in Medical Physics
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    • v.9 no.1
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    • pp.11-21
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    • 1998
  • Circular metal electrodes were vacuum-deposited with chromium on the both sides of Teflon-FEP and PET film characteristic of electret and the physical properties of the two polymers were observed during an irradiation by gamma-ray from $\^$60/Co. With the onset of irradiation of output 25.0 cGy/min the induced current increased rapidly for 2 sec, reached a maximum, and subsequently decreased. A steady-state induced current was reached about in 60 second. The dielectric constant and conductivity of Teflon-FEP were changed from 2.15 to 18.0 and from l${\times}$l0$\^$-17/ to 1.57${\times}$10$\^$-13/ $\Omega$-$\^$-1/cm$\^$-1/, respectively. For PET the dielectric constant was changed from 3 to 18.3 and the conductivity from 10$\^$-17/ to 1.65${\times}$10$\^$-13/ $\Omega$-$\^$-1/cm$\^$-1/. The increase of the radiation-induced steady state current I$\^$c/, permittivity $\varepsilon$ and conductivity $\sigma$ with output(4.0 cGy/min, 8.5 cGy/min, 15.6 cGy/min, 19.3 cGy/min) was observed. A series of independent measurements were also performed to evaluate reproducibility and revealed less than 1% deviation in a day and 3% deviation in a long term. Charge and current showed the dependence on the interval between measurements, the smaller the interval was, the bigger the difference between initial reading and next reading was. At least in 20 minutes of next reading reached an initial value. It may indicate that the polymers were exhibiting an electret state for a while. These results can be explained by the internal polarization associated with the production of electron-hole pairs by secondary electrons, the change of conductivity and the equilibrium due to recombination etc. Heating to the sample made the reading value increase in a short time, it may be interpreted that the internal polarization was released due to heating and it contributed the number of charge carriers to increase when the samples was again irradiated. The linearity and reproducibility of the samples with the applied voltage and absorbed dose and a large amount of charge measured per unit volume compared with the other chambers give the feasibility of a radiation detector and make it possible to reduce the volume of a detector.

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