• Journal of Gastric Cancer
• /
• v.4 no.4
• /
• pp.230-234
• /
• 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 Gastric Cancer
• /
• v.4 no.4
• /
• pp.213-218
• /
• 2004

Purpose: The superficial spreading type of early gastric cancer has different clinicopathologic features from other types of early gastric cancer in terms of its invasiveness and lymph-node metastases. Therefore, we attempted to elucidate the pathological features, surgical procedures and patients prognoses. Materials and Methods: Clinical information was reviewed for patients who had undergone a gastrectomy for gastric cancer during an 8-year period ($1995\~2002$) at Dankook University Hospital and Ulsan University, with an average follow-up of 48 months. Three hundred (300) superficial spreading lesions were analyzed with respect to macroscopic type, lymph-node (LN) metastasis, recurrent pattern, survival rate and method of surgical operation. In addition, the clinicopathological features of the superficial spreading type were compared with those of 739 other patients with small-sized cancer. Results: In both groups, the IIc-type macroscopic lesion, the elevated subtype to be more specific, occurred most frequently. There was no significant difference in the method of surgery between the groups. The submucosal invasion was $39.8\%$ in small-sized cancer, and $61.7\%$ in superficial spreading cancer (P=0.005). The incidence of LN metastasis was $11.3\%$ in early gastric cancer, $7.8\%$ in small-sized cancer and $20.0\%$ in superficial spreading cancer (P=0.005). The incidence of lymphatic invasion was $4.6\%$ in small-sized cancer and $13.0\%$ in superficial spreading cancer (P=0.009). The incidence of recurrence was $1.4\%$ in small-sized cancer and $3.6\%$ in superficial spreading cancer. The overall 5-year survival rate was $84.8\%$ in superficial spreading cancer and $93.0\%$ in small-sized cancer (P=0.052). The 5-year diseasefree survival rate was $94.7\%$ in superficial spreading cancer and $87.5\%$ in small-sized cancer (P=0.053). Conclusion: The superficial spreading type of early gastric cancer tends to be more invasive and to show a higher incidence of lymph-node metastasis than small-sized early gastric cancer. A wide resection with extensive lymph-node dissection seems to be an appropriate treatment for a superficial spreading type of early gastric cancer.

• Journal of Gastric Cancer
• /
• v.9 no.4
• /
• pp.207-214
• /
• 2009

Purpose: Subtotal distal gastrectomy has been accepted as the standard treatment for early gastric cancer that's developed on the gastric body. EMR and ESD have been introduced to minimize the incidence of postgastrectomy syndrome, but these procedures can not detect lymph node metastasis and they have a risk for gastric perforation. Segmental gastrectomy has recently been applied for treating early gastric cancer, but its usefulness has not been clarified. The aim of this study was to compare segmental gastrectomy and distal gastrectomy with Billroth I reconstruction for treating early gastric cancer that's developed on the gastric body. Materials and Methods: We performed a retrospective review of all the patients who were diagnosed as having early gastric cancer that developed on the gastric body at Chungnam National University Hospital from January 2004 through July 2007. During this period, 41 patients received segmental gastrectomy and 40 patients underwent subtotal distal gastrectomy. All the patients were studied via a biannual review of the body systems, a physical examination, endoscopy, computed tomography and the laboratory findings. Results: There were no significantly differences of the clinicopathologic characteristics between the two groups. The changes of the nutritional status (Hb, TP, Alb and TC) and the body weight change were not significantly different between the 2 groups. There were significantly more residual food in the SG group than that in the SDG group (RGB classification, Residual>Grade 2), but there were no differences for epigastric discomfort (P>0.05). Esophagitis developed at a similar rate for both two groups (LA classification, >Grade A), and bile reflux was found in only one patient of each group. Conclusion: We expected the reduction of esophagitis and gastritis and the improvement of nutritional status according to the type of procedure. Yet the results of our study showed no significant differences between the two study groups. More patients and a longer follow up time are needed for determining the advantage sand disadvantages of segmental gastrectomy.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.32 no.3
• /
• pp.218-228
• /
• 2010

Components of dental resin-based restorative materials are reported to leach from the filling materials even after polymerization. Hydroquinone (HQ) is one of the major monomers used in the dental resin and is known as a carcinogen. Thus, carcinogenic risk of HQ leaching from the dental resin becomes a public health concern. The present study attempted to examine the carcinogenic potentials of HQ on the human epithelial cell, which is the target cell origin of the most of oral cancers. Cytotoxicity of HQ was observed above 50${\mu}M$ as measured by LDH assay, indicating a relatively low toxicity of this substance in human epithelial cells. The parameters of neoplastic cellular transformation such as cell saturation density, soft agar colony formation and cell aggregation were analyzed to examine the carcinogenic potential of HQ. The study showed that 2-week exposure of HQ showed the tendency of increase in the saturation density and the significant enhancement of soft agar colony formation at the highest dose, 50 ${\mu}M$ only. It is suggested that HQ has a weak potential of carcinogenicity. When cells were treated with HQ and TPA, a well-known tumor promoter, the parameters of neoplastic cellular transformation was significantly increased. This result indicates that the potential risk of carcinogenicity from HQ is largely dependent upon the presence of promoter. Exposure of 50 ${\mu}M$ HQ increased the time-dependent apoptosis as measured by the ELISA kit. This concentration coincides with a dose of neoplastic transformation, indicating a possible link between apoptosis and HQ-induced cellular transformation. Hydroquinone generated Reactive Oxygen Species (ROS) which was evidenced by the treatment of antioxidants such as trolox and N-acetyl cysteine and the GSH depleting agent, BSO. Antioxidants blocked the generation of ROS and the GSH depleting agent, BSO dramatically increased the ROS production. Since HQ is known to increase ROS production thru activation of transcriptional factor such as c-Myb and Pim-1, it is speculated that ROS generation by HQ plays a role in the activation of oncogene, which may lead to neoplastic transformation. In addition, ROS is involved in the alteration of signal transduction, which regulates the apoptosis in many cellular systems. Thus, ROS-mediated apoptosis may be involved in the HQ-induced carcinogenic processes. Protein kinase C (PKC) is known to play pivotal roles in neoplastic transformation of cells and its high expression is often found in a variety of types of tumors including oral cancer. PKC translocation of PKC-${\alpha}$ was observed following HQ exposure. Altered signaling system may also play a role in the transformation process. Taken together, HQ leached from the dental resin does not pose a significant threat as a cancer causing agent, but its carcinogenic potential can be significantly elevated in the presence of promoter. The mechanism of HQ-induced carcinogenesis involved ROS generation, apoptosis and altered signaling pathway. The present study will provide a valuable data to estimate the potential risk of HQ as a carcinogen and understand mechanism of HQ-induced carcinogenesis in human epithelial cells.

• Journal of agricultural medicine and community health
• /
• v.24 no.1
• /
• pp.49-63
• /
• 1999

The objective of the study was to examine and compare health behavior between rural area and urban area in Soonchun city. Data were collected through personal interviews from 25, April to 30, May in 1998. Questions were asked to the rural area residents(n=399) and urban area residents(n=149) about their health behaviors, including such as self-recognition of health status, health related behaviors(smoking, drinking, eating habit, and exercising), status of disease and prevention, and utilization of hospital. As we examine the demographic characteristics, rural area residents were more aged(p<0.001) than urban area residents. And the urban residents had higher education(p<0.01), higher income(p<0.01) and higher health care cost(p<0.01) than rural residents. There were difference in health status existed between rural and urban residents. Rural residents had poorer health status(p<0.01) than urban residents, and however urban residents had more anxiety about their health(p<0.01) than rural residents. Comparison of the health related behavior between rural and urban area residents, rural residents were more likely to smoke(p<0.05), less intake of milk(p<0.01), do not exercise(p<0.01), and less try to lose their weight(p<0.01) than urban residents. Rural resident used to suffer from chronic diseases than urban residents(p<0.01). Consideration of health care need for rural residents are required due to the results shown as above. Therefore, the health care center, where most of the rural residents depend on for their treatment and prevention of disease, should make inquiries about resident's health care need and evaluate the important information sources for construction of a health care information system.

• The Journal of Korean Academy of Prosthodontics
• /
• v.50 no.3
• /
• pp.162-168
• /
• 2012

Purpose: Teeth are generally exposed when people smiling. Moreover, the exposed teeth and soft tissue when smiling becomes an important guideline for esthetically prosthetic restoration. This research is to compare and find out differences of Korean young men's smile living in presence and twenty years ago. Materials and methods: Subjects, 100 young men (50 male and 50 female), were required about several aspects; normally developed physical condition, no psychological or genetic disorders, a fine face with no loss of teeth, no experience in orthodontic or prosthetic treatment, relatively normal occlusion, aged between 20-29. The photos of the subject at rest position and front face when fully smiled were taken three times. 100 photos (50 male and 50 female) were chosen at random from the 240 university students' smile photos taken by Yoon and his colleagues in 1991. By Hulsey's method of measuring smile, several factors; the change of upper lip curvature, the change of the relation between the upper lip and teeth, parallelism between Mx. incisor and lower lip, contact relation between Mx. incisor and lower lip and teeth displayed in a smile, were measured and analyzed. Meanwhile, ten dentists assessed aesthetic evaluation about men and women's smile for twice and recorded and compared smile score. The -test (P<.05) was used to compare the measured value. The difference of smile score was analyzed by t-test (P<.05). Results: The smile score calculated in 2011 (60.22) was higher than that of 1991 (52.80). Among five measurement categories, the noticeable difference was distinguished from two factors; the change of upper lip curvature and contact relation between Mx. incisor and lower lip. Conclusion: The Korean young men's smile has been considerably improved for twenty years. And it is found that the change of upper lip curvature plays an important role, that is, the smile formed with an ascended labial commissure has been increased significantly.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.31 no.3
• /
• pp.362-371
• /
• 2004

It is essential to have adequate knowledge of the timing of root resorption of deciduous teeth for diagnosis and treatment planning in pediatric and orthodontic dentistry. Dental development is also influenced by hereditary characteristics, environmental factors, race, sex, endocrine reaction, nutrition, socioeconomic condition and secular factor. The aims of the present study were to determine the mean age of root resorption of deciduous teeth in contemporary Korean children and to compare the mean age of root resorption time of deciduous teeth between early 1990s and early 2000s. The study population was made up of Korean children attending the pediatric dentistry ward of Kyungpook National University Hospital. One thousand thirty seven children's panoramic radiograph (girls: 528 persons, boys: 509 persons) in $1990{\sim}1992$ and one thousand sixty five children's panoramic radiograph (girls: 394 persons, boys: 671 persons) in $2001{\sim}2003$ were examined. This study utilized a cross-sectional design. Due to the problems of imaging in the maxillary region and the mandibular incisor region, the mandibular deciduous canine, the mandibular deciduous first molar and the mandibular deciduous second molar were chosen for examination. The results were as follows. 1. There is a tendency for the teeth to resort earlier in the early 2000s group than the in early 1990s group. At the Res c stage, the difference of the mean age was 0.4 years. 2. At the Res c stage, the order of difference of the mean age from smaller to larger for the girls was the mandibular deciduous canine, the mandibular first deciduous molar, and the mandibular second deciduous molar. On the other hand, for the boys, the order was the mandibular second deciduous molar, the mandibular first deciduous molar, and the mandibular deciduous canine. The difference was larger with aging in girls and smaller with aging in boys. 3. There is a tendency for the teeth to resort earlier in girls in both the early 1990s group and the early 2000s group. The difference of the mean age between girls and boys was 0.3 year. 4. The commencement of root resorption of the mandibular deciduous canine was slower than that of the mandibular first deciduous molar. However, the completion of root resorption of the mandibular deciduous canine is faster than that of the mandibular first deciduous molar. The total elapsed time of root resorption from commencement to completion was shortest in the mandibular deciduous canine. 5. For each of the teeth in the early 1990s and the early 2000s groups, the speed of root resorption was in the later stage faster than in the earlier stage. In order to know about the exact timing of root resorption of deciduous teeth, periodic and longitudinal studies preferably covering the entire period of growth, is required.

• Advances in pediatric surgery
• /
• v.4 no.1
• /
• pp.39-47
• /
• 1998

Infantile hypertrophic pyloric stensosis(IHPS) occurs in three of 1000 live births, and is a major cause of nonbilious vomiting of early infancy. It's etiology and pathogenesis however are still obscure. The operation of pyloromyotomy described by Ramstedt in 1912 remains the standard treatment. From January 1990 to July 1997, 64 infants with IHPS were treated at the Department of Pediatric Sursery, Yeungnam University Hospital. The ratio of male to female was 7:1, and the most prevalent age ranged from 2 weeks to 8 weeks(81.2 %) of age. Fifty-seven infants were first born (57.8 percent). The body weight of all patients at admission was below the 50 percentile. Age of onset of symptoms was between 2 and 4weeks of age in 23 cases(35.9 %). All infants had a history of nonbilious vomting, generally projectile in nature. Hypokalemia was noted in 14 cases(21.9 %) and hypochloremia in 26 cases(40.6 %). In the preoperative ultrasonography, the average muscle thickness, diameter, and length of the pylorus were 6.3 mm, 12.3 mm, and 17.8 mm. A total of 13 associated anomalies were noted in 12 patients. All cases were treated with Fredet-Ramstedt pyloromyotomy. Postoperative wound infection occured in 3 cases. Thirteen cases(20.3 %) presented intermittent nonprojectile vomiting after operation. With control of oral intake vomiting subsided within one week in 63 patients, and in thirteen days in another.

• Journal of Gastric Cancer
• /
• v.7 no.4
• /
• pp.206-212
• /
• 2007

Purpose: The number of laparoscopy assisted distal gastrectomies (LADG) is gradually increasing for the treatment of early gastric cancer (EGC) patients as a surgical modality for improving quality of life. However, there are few reports on laparoscopy-assisted total gastrectomy (LATG), mainly because this procedure is performed relatively infrequently, and the procedure is more complicated than LADG. This study was performed to evaluate the technical feasibility, safety, and surgical results of LATG with lymphadenectomy through a review of our experience. Materials and Methods: From July 2003 to June 2007, 77 LATG with Roux-en-Y esophagojejunostomy were performed for patients with a preoperative diagnosis of EGC. The clinicopathological features and surgical outcomes were analyzed. Results: There were 49 males and 28 females in the study with a mean age of 61 years (range $30{\sim}85$ years). The mean operation time was 210 minutes (range $100{\sim}400$ minutes) and the operation time was gradually decreased as the case numbers increased. There were 13 operative morbidities (16.9%) and no operative mortalities. The restoration of bowel motility was noted at 3.2 postoperative days; a soft diet was started at 4.4 postoperative days and the duration of hospital stay was 10 days. There were 20 mucosal lesions, 32 submucosal lesions, 15 proper muscle lesions, 7 subserosal lesions and 3 serosal lesions. A total of 20 patients were treated by D2 lymph node dissection, 55 patients were treated by D1+$\beta$ lymph node dissection, and two patients were treated by D1+$\alpha$ lymph node dissection. The mean number of retrieved lymph nodes was 42 (range $11{\sim}86$). Lymph node metastases were noted in 12 patients. Conclusion: This study indicated LATG could be applied safely and effectively for patients with EGC. However, a prospective study comparing laparoscopy-assisted versus open gastrectomy for short-term and long-term surgical outcome is needed.

• Tuberculosis and Respiratory Diseases
• /
• v.49 no.1
• /
• pp.72-81
• /
• 2000

Backgrounds : Authors evaluated the quantitative culture of bronchoalveolar lavage fluid(BALF) in patients who were being treated with antimicrobial agents and the characteristics of isolated microorganism. Method : A prospective study was done with 25 patients under mechanical ventilation and antimicrobial treatment in ICU and NCU of Yongdong Severance Hospital from Apr. to Sep. 1999. Patients were classified into two groups: control group (n=5) and patients with VAP (n=20). The threshold of quantitative culture of BAL fluid in the diagnosis of VAP was $10^4$ cfu/ml. Results : 1) In gram staining of BALF, one patient in the control group and four in the VAP group showed positive results. Quantitative culture of BALF showed no organisms in the patients in the control group and in 9 VAP patients. Therefore the overall sensitivity was 43.8%. 2) Frequency of isolated organisms cultured above diagnostic threshold was in the following order: E. cloaclae, S. aureus, K. pneumoniae, and A. baumani. S. aureus and Staphylococcus coagulase(-) were a11 resistant to oxacillin. Seven out of 10 isolated G (-) organisms were suspected to be organisms producing extended spectrum $\beta$-lactamase (ESBL). 3) The concurrence between gram staining of sputum aspiration and that of BALF was only in 1 case. And the concurrence of culture results was observed in 3 cases. Conclusion : The sensitivity of gram staining and quantitative culture of BALF from patients under antibiotic therapy and the concordance rate between conventional tracheal aspiration and BAL were low, facts which were important in interpretation the data. Since the frequency of drug resistance organisms was not different from that of foreign data, antibiotics must be prudently selected and used.