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Emerging Role of Robot-assisted Gastrectomy: Analysis of Consecutive 200 Cases

  • Park, Ji Yeon;Kim, Young-Woo;Ryu, Keun Won;Eom, Bang Wool;Yoon, Hong Man;Reim, Daniel
    • Journal of Gastric Cancer
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    • v.13 no.4
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    • pp.255-262
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    • 2013
  • Purpose: Robotic surgery for gastric cancer is a promising alternative to laparoscopic surgery, but the data are limited. We aimed to evaluate whether gaining experience in robotic gastrectomy could improve surgical outcomes in the treatment of gastric cancer. Materials and Methods: Two hundred and seven consecutive cases of patients with clinical stage I gastric cancer who underwent robotic surgery at the National Cancer Center of Korea between February 2009 and February 2012 were retrospectively reviewed. Surgical outcomes were analyzed and compared between the initial 100 and later 100 cases. Results: Seven patients required conversion to open surgery and were excluded from further analysis. The mean operating time for all patients was 248.8 minutes, and mean length of hospitalization was 8.0 days. Twenty patients developed postoperative complications. Thirteen were managed conservatively, while 6 had major complications requiring invasive procedures. One mortality occurred owing to myocardial infarction. Operating time was significantly shorter in the latter 100 cases than in the initial 100 cases (269.9 versus 233.5 minutes, P<0.001). The number of retrieved lymph nodes was significantly greater in the latter cases (35.9 versus 39.9, P=0.032). The hospital stay of patients with complications was significantly longer in the initial cases than in the latter cases (16 versus 7 days, P=0.005). Conclusions: Increased experience with the robotic procedure for gastric cancer was associated with improved outcomes, especially in operating time, lymph node retrieval, and shortened hospital stay of complicated patients. Further development of surgical techniques and technology might enhance the role of robotic surgery for gastric cancer.

One Year Naturalistic Outcome Study of Panic Disorder Patients (공황장애 환자의 1년 자연 경과 추적 연구)

  • Kim, Min-Hoo;Lee, Dong-Eoun;Chung, Seock-Hoon;Song, Hae-Cheol;Hahn, Oh-Su;Lee, Seon-Hyung;Kwon, Soo-Hee;Hong, Jin-Pyo
    • Anxiety and mood
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    • v.2 no.2
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    • pp.108-114
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    • 2006
  • Objectives : Only a few prospective studies of panic disorder are available. This study investigated naturalistic outcome of panic disorder patients at twelve months after the initial diagnosis. Methods : A total of 84 subjects were diagnosed with panic disorder by diagnostic interview, Structured Clinical Interview for DSM-IV (SCID-IV) and Anxiety Disorder Interview Schedule for DSM-IV (ADISIV). Among them, 80 subjects could be evaluated by means of Panic Disorder Severity Scale (PDSS) at follow-up interview after twelve months. Treatment continuation was also examined at follow-up interview. Results : At initial intake, 80 patients were classified into 22% with mild, 33% with moderate-to-marked, and 45% with severe symptoms on the basis of their PDSS total score. At twelve months, 20% of patients reached remission, 65% had mild and 15% had moderate-to-marked symptoms. Initial panic symptom severity, presence of agoraphobia, panic symptom duration before diagnosis, number of comorbid Axis I disorders were associated with significantly higher PDSS total score at twelve months. Forty six percent of total patients continued medication and 23% have stopped treatment by clinician's recommendation and 31% have selfdiscontinued their medication. At twelve months, all three groups were improved but self-discontinuation group had significantly higher PDSS total score. Conclusion : In the one-year naturalistic outcome study of panic disorder patients, high percentage of patients achieved remission or had mild symptoms.

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A Study on the resistance of acrylic rubber pressure sensitive adhesives with curing agents and tackifiers (경화제와 점착부여제가 아크릴 고무점착제의 내열성에 미치는 영향)

  • Nam, Kyong min;Kim, Chul Yong;Kim, Eun Seon;Kim, Kwang-Je;Choi, Woo Jin;Kim, Ki-Tae;Park, Myung-Chul
    • Journal of Adhesion and Interface
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    • v.18 no.4
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    • pp.166-170
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    • 2017
  • In this study, acrylic rubber pressure sensitive adhesives was polymerized with 2-ethylhexyl acrylate, styrene, butadiene, 2-hydroxyethyl acrylate, and acrylic acid by controlling the initiator content. The initial tackiness, peel strength, holding power, and heat resistance of the PSAs were investigated by changing the content of tackifier and curing agent. The results showed that the initial tackiness and peel strength increased as the content of tackifier increased, whereas the holding power decreased. Also, the results exhibited that that the initial tackiness, peel strength, and heat resistance decreased as the content of curing agent increased, whereas the holding power and decreased.

Psychological effects and risk perception after genetic counseling

  • Shin, Sunghwan;Ryu, Mi Ra;Kwon, Won Kyung;Kim, Suhee;Jang, Ja-Hyun;Kim, Jong-Won
    • Journal of Genetic Medicine
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    • v.18 no.1
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    • pp.38-43
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    • 2021
  • Purpose: Demand for genetic counseling on cancer predisposition syndrome is increasing. We evaluated the psychological effect on counselees after genetic counseling at a clinic in a single center. Materials and Methods: We surveyed a total of 72 enrolled participants who visited a genetic counseling clinic at the Samsung Medical Center (SMC). The initial survey was conducted before the first genetic counseling session, and the second survey was conducted after the second genetic counseling session. A total of 43 participants completed both the initial and second surveys. Results: The initial survey of 72 participants indicated higher feelings of guilt in the group with religion, higher depression and anxiety in the group with a diagnosis of self, and higher anxiety in the group on self-referral to the genetic counseling clinic. In the completed survey of 43 participants, overall decreased depression was observed after the second genetic counseling session (P=0.013). Risk perception and anxiety decreased in the group diagnosed with benign variant/variant of uncertain significance (BV/VUS, 25/3) and increased in the group diagnosed with pathogenic variant (PV, 15). Risk perception and anxiety differed between the BV/VUS and PV groups (P<0.001 and P=0.03, respectively). Conclusion: The genetic counseling clinic at the SMC was effective in ameliorating the depression score. Assessment of survey results revealed different depression scores, feelings of guilt and anxiety, and different effects of the genetic counseling clinic, depending on the subgroups. Understanding the needs and psychological characteristics of different groups is necessary for improving genetic counseling services.

The Application of 3D Bolus with Neck in the Treatment of Hypopharynx Cancer in VMAT (Hypopharynx Cancer의 VMAT 치료 시 Neck 3D Bolus 적용에 대한 유용성 평가)

  • An, Ye Chan;Kim, Jin Man;Kim, Chan Yang;Kim, Jong Sik;Park, Yong Chul
    • The Journal of Korean Society for Radiation Therapy
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    • v.32
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    • pp.41-52
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    • 2020
  • Purpose: To find out the dosimetric usefulness, setup reproducibility and efficiency of applying 3D Bolus by comparing two treatment plans in which Commercial Bolus and 3D Bolus produced by 3D Printing Technology were applied to the neck during VMAT treatment of Hypopahrynx Cancer to evaluate the clinical applicability. Materials and Methods: Based on the CT image of the RANDO phantom to which CB was applied, 3D Bolus were fabricated in the same form. 3D Bolus was printed with a polyurethane acrylate resin with a density of 1.2g/㎤ through the SLA technique using OMG SLA 660 Printer and MaterializeMagics software. Based on two CT images using CB and 3D Bolus, a treatment plan was established assuming VMAT treatment of Hypopharynx Cancer. CBCT images were obtained for each of the two established treatment plans 18 times, and the treatment efficiency was evaluated by measuring the setup time each time. Based on the obtained CBCT image, the adaptive plan was performed through Pinnacle, a computerized treatment planning system, to evaluate target, normal organ dose evaluation, and changes in bolus volume. Results: The setup time for each treatment plan was reduced by an average of 28 sec in the 3D Bolus treatment plan compared to the CB treatment plan. The Bolus Volume change during the pretreatment period was 86.1±2.70㎤ in 83.9㎤ of CB Initial Plan and 99.8±0.46㎤ in 92.2㎤ of 3D Bolus Initial Plan. The change in CTV Min Value was 167.4±19.38cGy in CB Initial Plan 191.6cGy and 149.5±18.27cGy in 3D Bolus Initial Plan 167.3cGy. The change in CTV Mean Value was 228.3±0.38cGy in CB Initial Plan 227.1cGy and 227.7±0.30cGy in 3D Bolus Initial Plan 225.9cGy. The change in PTV Min Value was 74.9±19.47cGy in CB Initial Plan 128.5cGy and 83.2±12.92cGy in 3D Bolus Initial Plan 139.9cGy. The change in PTV Mean Value was 226.2±0.83cGy in CB Initial Plan 225.4cGy and 225.8±0.33cGy in 3D Bolus Initial Plan 224.1cGy. The maximum value for the normal organ spinal cord was the same as 135.6cGy on average each time. Conclusion: From the experimental results of this paper, it was found that the application of 3D Bolus to the irregular body surface is more dosimetrically useful than the application of Commercial Bolus, and the setup reproducibility and efficiency are excellent. If further case studies along with research on the diversity of 3D printing materials are conducted in the future, the application of 3D Bolus in the field of radiation therapy is expected to proceed more actively.

Improved Gradient Direction Assisted Linking Algorithm for Linear Feature Extraction in High Resolution Satellite Images, an Iterative Dynamic Programming Approach

  • Yang, Kai;Liew, Soo Chin;Lee, Ken Yoong;Kwoh, Leong Keong
    • Proceedings of the KSRS Conference
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    • 2003.11a
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    • pp.408-410
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    • 2003
  • In this paper, an improved gradient direction assisted linking algorithm is proposed. This algorithm begins with initial seeds satisfying some local criteria. Then it will search along the direction provided by the initial point. A window will be generated in the gradient direction of the current point. Instead of the conventional method which only considers the value of the local salient structure, an improved mathematical model is proposed to describe the desired linear features. This model not only considers the value of the salient structure but also the direction of it. Furthermore, the linking problem under this model can be efficiently solved by dynamic programming method. This algorithm is tested for linear features detection in IKONOS images. The result demonstrates this algorithm is quite promising.

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Isolated Tricuspid Regurgitation: Initial Manifestation of Cardiac Amyloidosis

  • Yoon, Dong Woog;Park, Byung-Jo;Kim, In Sook;Jeong, Dong Seop
    • Journal of Chest Surgery
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    • v.48 no.6
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    • pp.422-425
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    • 2015
  • Amyloid deposits in the heart are not exceptional in systemic amyloidosis. The clinical manifestations of cardiac amyloidosis may include restrictive cardiomyopathy, characterized by progressive diastolic and eventually systolic biventricular dysfunction; arrhythmia; and conduction defects. To the best of our knowledge, no previous cases of isolated tricuspid regurgitation as the initial manifestation of cardiac amyloidosis have been reported. We describe a rare case of cardiac amyloidosis that initially presented with severe tricuspid regurgitation in a 42-year-old woman who was successfully treated with tricuspid valve replacement. Unusual surgical findings prompted additional evaluation that established a diagnosis of plasma cell myeloma.

Wear Debris Analysis using the Color Pattern Recognition

  • Chang, Rae-Hyuk;Grigoriev, A.Y.;Yoon, Eui-Sung;Kong, Hosung;Kang, Ki-Hong
    • KSTLE International Journal
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    • v.1 no.1
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    • pp.34-42
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    • 2000
  • A method and results of classification of four different metallic wear debris were presented by using their color features. The color image of wear debris was used far the initial data, and the color properties of the debris were specified by HSI color model. Particles were characterized by a set of statistical features derived from the distribution of HSI color model components. The initial feature set was optimized by a principal component analysis, and multidimensional scaling procedure was used fer the definition of a classification plane. It was found that five features, which include mean values of H and S, median S, skewness of distribution of S and I, allow to distinguish copper based alloys, red and dark iron oxides and steel particles. In this work, a method of probabilistic decision-making of class label assignment was proposed, which was based on the analysis of debris-coordinates distribution in the classification plane. The obtained results demonstrated a good availability for the automated wear particle analysis.

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Refolding of Proteins at High Concentration by Size Exclusion Chromatography

  • Guan, Yixin;Gao, Yonggui;Yao, Shanjing;Cho, Man-Gi
    • Proceedings of the Korean Society of Life Science Conference
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    • 2002.09a
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    • pp.9-17
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    • 2002
  • Renaturation of Lysozyme by size exclusion chromatography(SEC) to improve yield as well as the initial and final protein concentration has been studied in detail, Although urea decreases the rate of proteins refolding, it can suppress protein aggregation to sustain pathway of correct refolding at high protein concentration, and there existed an optimum urea concentration in renaturation buffer. Lysozyme was successfully refolded from initial protein concentration of up to 100mg/m1 by SEC, the yield was more than 40%. And the refolding of Interferon-${\gamma}$ was further investigated.

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A initial cluster center selection in FCM algorithm using the Genetic Algorithms (유전 알고리즘을 이용한 FCM 알고리즘의 초기 군집 중심 선택)

  • 오종상;정순원;박귀태
    • Proceedings of the Korean Institute of Intelligent Systems Conference
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    • 1996.10a
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    • pp.290-293
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    • 1996
  • This paper proposes a scheme of initial cluster center selection in FCM algorithm using the genetic algorithms. The FCM algorithm often fails in the search for global optimum because it is local search techniques that search for the optimum by using hill-climbing procedures. To solve this problem, we search for a hypersphere encircling each clusters whose parameters are estimated by the genetic algorithms. Then instead of a randomized initialization for fuzzy partition matrix in FCM algorithm, we initialize each cluster center by the center of a searched hypersphere. Our experimental results show that the proposed initializing scheme has higher probabilities of finding the global or near global optimal solutions than the traditional FCM algorithm.

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