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.
The 22q11.2 duplication syndrome is an extremely variable disorder with a phenotype ranging from normal to congenital defects and learning disabilities. Recently, the detection rate of 22q11.2 duplication has been increased by molecular techniques, such as array CGH. In this study, we report a familial case of 22q11.2 duplication detected prenatally. Her first pregnancy was terminated because of 22q11.2 duplication detected incidentally by BAC array CGH. The case was referred due to second pregnancy with same 22q11.2 duplication. We perfomed repeat amniocentesis for karyotype and FISH analysis. Karyotype analysis from amniocytes and parental lymphocytes were normal, while FISH analysis of interphase cells presented a duplication of 22q11.2 in the fetus and phenotypically normal mother. The fetal ultrasound showed grossly normal finding. After genetic counseling about variable phenotype with intrafamilial variability with 50% recurrence rate, the couple decided to continue the pregnancy. The newborn had no apparent congenital abnormalities until 2 weeks after birth. We recommend that family members of patients with a 22q11.2 duplication be tested by the interphase FISH analysis. Also, we point out the importance of genetic counseling and an evaluation of the clinical relevance of diagnostic test results.
Position information of radiation interactions in detection material is essential to reconstruct a radiation source image. With most position sensing techniques, the position information of a single interaction inside the detectors can be precisely obtained. Each interaction position of multi-scattering inside scintillators, however, can not be individually measured and only the average of the scattering positions can be obtained, which causes the uncertainty in the measured interaction position. In this paper, the position uncertainties due to the multi-scattering were calculated by Monte Carlo simulation. The simulation model was a 50 by 50 by 5 mm $LaCl_3$(Ce) scintillator(pixel size is 2 by 2 by 5mm) which was utilized for the dual collimation camera. The dual collimation camera uses the information from both photoelectric effect and Compton scattering, and therefore, position uncertainties for both partial and full energy deposition of radiation interactions are calculated. In the case of partial energy deposition(PED), the standard deviations of positions are less than $1{\sim}2mm$, which means the uncertainty caused by multi-scattering is not significant. Because the effect of the multi-scattering with PED is insignificant, the multi-scattering has little effect on the performance of Compton imaging of dual collimation camera. In the case of full energy deposition(FED), however, the standard deviation of the positions is about twice that of the pixel size of the 1stdetector, except for 122keV incident radiations. Therefore, the standard deviations caused by multi-scatterings should be considered in the design of the coded mask of the dual collimation camera to avoid artifact on the reconstructed image. The position uncertainties of the FEDs are much larger than those of the PEDs for all radiation energies and the ratio of PEDs to FEDs increases when the incident radiation energy increases. The position uncertainties of both PEDs and FEDs are dependent on the incident radiation energy.
Purpose: We previously reported that concurrent reactivation of latent Epstein-Barr virus (EBV) in children with hepatitis A virus (HAV) infection is common and EBV reactivation with HAV infection adversely affects the clinical features of hepatitis. However, the incidence of concurrent reactivation was not accurate because the detection of EBV reactivation was based on serologic methods. Therefore, we studied the effects of polymerase chain reaction (PCR)-proven EBV reactivation, thus a more precise concurrence, on acute HAV infection in children. Methods: PCR were conducted in 34 patients, who had enrolled previous study and diagnosed with acute HAV infection between January 2008 and June 2010. Their medical records were reviewed. Results: Among 34 patients with acute HAV infection, 12 patients (35.3%) had EBV reactivation which was proven using serologic and molecular biologic techniques. There were significant differences in the peak levels of AST and ALT between the reactivated and non-reactivated groups (p=0.001 and p<0.001, respectively). The duration of full recovery from hepatitis was more prolonged in the reactivated group (p<0.001). Clinical parameters, such as serum protein (p<0.001) and albumin concentrations (p<0.001), atypical lymphocyte count (p=0.001), prothrombin time-international normalized ratio (PT-INR, p<0.001), and splenomegaly (p<0.001), showed significant differences. The clinical features in the reactivated sub-group >10 years of age revealed more liver dysfunction compared to the non-reactivated sub-group. A comparison with a previous study was performed. Conclusion: PCR-proven reactivation of latent EBV in children with HAV infection is common and EBV reactivation with HAV infection adversely affects the clinical features of hepatitis, especially in older children.
Data mining is an information extraction activity to discover hidden facts contained in databases. Using a combination of machine learning, statistical analysis, modeling techniques and database technology, data mining finds patterns and subtle relationships in data and infers rules that allow the prediction of future results. Typical applications include market segmentation, customer profiling, fraud detection, evaluation of retail promotions, and credit risk analysis. Law enforcement agencies deal with mass data to investigate the crime and its amount is increasing due to the development of processing the data by using computer. Now new challenge to discover knowledge in that data is confronted to us. It can be applied in criminal investigation to find offenders by analysis of complex and relational data structures and free texts using their criminal records or statement texts. This study was aimed to evaluate possibile application of data mining and its limitation in practical criminal investigation. Clustering of the criminal cases will be possible in habitual crimes such as fraud and burglary when using data mining to identify the crime pattern. Neural network modelling, one of tools in data mining, can be applied to differentiating suspect's photograph or handwriting with that of convict or criminal profiling. A case study of in practical insurance fraud showed that data mining was useful in organized crimes such as gang, terrorism and money laundering. But the products of data mining in criminal investigation should be cautious for evaluating because data mining just offer a clue instead of conclusion. The legal regulation is needed to control the abuse of law enforcement agencies and to protect personal privacy or human rights.
A thermal neutron beam facility utilizing a typical tangential beam port for Neutron Capture Therapy was installed at the HANARO, 30 MW multi-purpose research reactor. Mixed beams with different physical characteristics and relative biological effectiveness would be emitted from the BNCT irradiation facility, so a quantitative analysis of each component of the mixed beams should be performed to determine the accurate delivered dose. Thus, various techniques were applied including the use of activation foils, TLDs and ionization chambers. All the dose measurements were perform ed with the water phantom filled with distilled water. The results of the measurement were compared with MCNP4B calculation. The thermal neutron fluxes were $1.02E9n/cm^2{\cdot}s\;and\;6.07E8n/cm^2{\cdot}s$ at 10 and 20 mm depth respectively, and the fast neutron dose rate was insignificant as 0.11 Gy/hr at 10 mm depth in water The gamma-ray dose rate was 5.10 Gy/hr at 20 mm depth in water Good agreement within 5%, has been obtained between the measured dose and the calculated dose using MCNP for neutron and gamma component and discrepancy with 14% for fast neutron flux Considering the difficulty of neutron detection, the current study support the reliability of these results and confirmed the suitability of the thermal neutron beam as a dosimetric data for BNCT clinical trials.
Background : An immunochromatographic assay (ICT Diagnostics) which facilitates the diagnosis of tuberculosis(TB) by detecting serum antibodies mainly directed against specific 38KDa of Mycobacterium tuberculosis has come into the market. The test consists of a cardboard folding device containing nitrocellulose strip and absorbent pads. The whole procedure is completed within 15 min and does not require any additional equipment. The test has been reported to be sensitive and specific in diagnosing active TB. Thus the test had been evaluated with sera from TB patients and TB-free subjects. Method : Sera from patients with active pulmonary tuberculosis(40 sputum positives for Mycobacterium tuberculosis, 79 sputum negatives, and 3 extrapulmonary tuberculosis) were obtained from the Double-Cross Chest Clinic of the Korean National Tuberculosis Association (KNTA) in Seoul. The control group consisted of TB-free 68 subjects(21 children under 7 years old and 47 healthy staff members of KNTA). Results : Nine out of 68(13.2%) TB-free controls had positive antibody response. Total 106 of 122(86.9%) radiologically active patients had positive antibodies while 16 (13.1%) showed negative reaction. Antibody was detected in 38 of 40(95.0%) sputum positive patients and 68 of 82(82.9%) sputum negative patients who were under the antituberculosis chemotherapy. The sensitivity and specificity were all 87% and the positive predictive value was 92.2% while the negative predictive value was 78.7%, when the prevalence of TB in the sample was 64.2%. Our results clearly show that the detection of antibodies which mainly react with the 38KDa antigen of M. tuberculosis is not suitable as the first-line method of diagnosis but considered only as an adjunctive test to standard techniques of tuberculosis diagnosis. when considering its high false positivity.
Journal of Korean Society of Environmental Engineers
/
v.31
no.10
/
pp.845-854
/
2009
There has been increased concern regarding the release of antibiotics to different environmental compartments due to the possibility of the development of antibiotic resistant bacteria. However, limited information is available regarding the occurrence, fate, and transport of antibiotics in Korea in both the aqueous phase and in solid phases such as sediment and soil. Therefore, this study was conducted to monitor the concentration of released antibiotics in surface water, sediment, and soil adjacent to a cattle manure composting facility in Korea. Specifically, the following six antibiotics were monitored: tetracycline (TC), chlortetracycline (CTC), oxytetracycline (OTC), sulfamethazine (SMT), sulfamethoxazole (SMX), and sulfathiazole (STZ). To extract and quantify the antibiotics from different environmental compartments, solid phase extraction (SPE) and high performance liquid chromatography mass spectrometry (HPLC/MS) techniques were adopted. The concentration of the six antibiotics ranged from below the detection limit (BDL) to 0.71 ${\mu}g$/L in surface water, from BDL to 27.61 ${\mu}g$/L in sediment, and from 0.12 to 157.33 ${\mu}g$/L in soil. In addition, higher concentrations of antibiotics were observed in surface water and sediment at locations closer to the composting facility indicating that composting is the source of the antibiotics found in the environment. Furthermore, higher concentrations of antibiotics were observed in the solid phase (sediment and soil) than the aqueous phase. These findings indicate that the possibility of antibiotic resistant bacteria is increased because such bacteria are more stable in the solid phase. Overall, longterm monitoring of the aqueous phase and solid phase is necessary to gain a better understanding of the impact of antibiotics from source on the environment in Korea.
Purpose: The five-year survival rate is over 95% for radically resected early gastric cancer. The development of diagnostic techniques enables early detection of gastric cancer, so the life expectancy of patients with early gastric cancer is prolonged. Therefore, a limited number of surgeries are performed these days for the purpose of increasing the quality of life. The purpose of this study is to assess the postoperative quality of life after a pylorus-preserving gastrectomy (PPG) compared with that after a subtotal gastrectomy with gastroduodenal anastomosis (B-I). Materials and Methods: One hundred seven (107) patients who underwent gastric surgery for early gastric cancer from January 1999 to December 2003 at the Department of Surgery of Chonnam National University Hospital were selected. We compared patients who underwent a PPG with those who underwent a B-I. The clinical results were compared by using the chi-square test and the Student's T-test. The data were considered to be significant when the P value was less than 0.05. Results: Twenty-nine patients (29) underwent a PPG, and the other seventy-eight (78) patients underwent a B-I. There was no significant difference between the two groups on sex, age, and postoperative abdominal symptoms. The patients who underwent a PPG showed shorter operation times and less reflux gastritis and esophagitis on endoscopic evaluation than the patients who underwent a B-I. Conclusion: The pylorus-preserving gastrectomy (PPG) is a more physiologic operation than the subtotal gastrectomy with gastroduodenal anastomosis (B-I) and improves the postoperative quality of life.
Samples of water, soil, and sediment were taken from 10 streams near Andong, Korea in May 2004. To assess the degree of environmental pollution of each stream, chemical pollutants such as total notrogen (T-N), total phosphorus (T-P), chemical oxygen demand (COD), heavy metals, organophosphorus pesticides, organochlorine pesticides, and dioxin-like PCB congeners were analyzed by standard process tests or U.S. EPA methods. In addition, biomarkers originated from insect immune systems of beet armyworm, Spodoptera exigua, were used to analysis of the environmental samples. Except Waya-chun stream showing T-N content of 9.12 mg/L, most streams were contaminated with relatively low levels of overall pollutants in terms of T-N, T-P, and COD, compared to their acceptable environmental levels designated by the Ministry of Environment. Contents of Pb and Cd in samples of each stream were much lower than environmentally permissible levels. However, several times higherconcentrations of Pb and Cd were found in locations at Mi-chun, Kilan-chun, and Hyunha-chun streams, in comparison with other streams. Diazinon, parathion, and phenthoate compounds among organophosphorus pesticides were detected as concentrations of 0.19, 0.40, and $1.13\;{\mu}g/g$, respectively, from soil sample collected in the vicinity of Mi-chun stream. On the other hand, 16 organochlorine pesticides and 12 dioxin-like PCB congeners, known as endocrine disrupting chemicals, selected in this study were not found above the limit of detection. Biomarker analyses using insect immune responses indicated that Waya-chun stream was suspected as exposure to environmental pollutants. Limitation and compensation of both environmental analysis techniques are discussed.
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