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Laparoscopy Assisted Total Gastrectomy with Lymph Node Dissection-77 Consecutive Cases (복강경 보조 위 전절제술-연속된 77예의 경험)

  • Lee, Joong-Ho;Song, Jye-Won;Oh, Sung-Jin;Kim, Sung-Soo;Choi, Won-Hyuk;Cheong, Jae-Ho;Hyung, Woo-Jin;Choi, Seung-Ho;Noh, Sung-Hoon
    • Journal of Gastric Cancer
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    • v.7 no.4
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    • pp.206-212
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    • 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.

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A Study on Clinical Progress of the Metastatic Adenocarcinoma of Pleura (전이성 흉막선암의 임상 경과에 관한 연구)

  • Yang, Seong-Wook;Lee, Tae-Kwan;Lee, Tae-Heon;Cho, Deok-Su;Baek, Hyeon-Seon;Kim, Ji-Young;Lee, Hye-Kyung;Kim, Kwi-Wan
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.2
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    • pp.156-164
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    • 1995
  • Background: We had undergone this study to investigate clinical progress of this disease and to decide the role of aggressive diagnostic approaches, the efficacy of treatments and prognoses. Methods: A retrospective study was done on 113 patients who had been diagnosed to metastatic adenocarcinoma of pleura by pleural fluid cytology(106 cases) or pleural needle biopsy(22 cases), at Presbyterian Medical Center, from Jan. 1990 to Dec. 1994. Results: 1) The patients were composed of 59 males(52.2%) and 54 females(47.8%), and the mean age distribution was $57.4{\pm}12.1$ years. 2) The site of origin was lung cancer 46.9%(53/113), stomach cancer 20.4%(23/113), breast cancer 11.5%(13/113), and unknown primary site 6.2%(7/113 cases), as a whole. In male, lung cancer was 55.9%(33/59), stomach cancer was 28.8%(17/59), and in female, lung cancer was 37%(20/54), breast cancer was 24.1%(13/54) of cases. 3) The cardinal symptoms were dyspnea(69%), cough(61%), chest pain(50%), weight loss(50%), anorexia(49%), sputum(43%), malaise(30%). 4) The pleural fluid findings were exudative in 94.4%(102/108), serosanguinous or bloody in 36~53%, unilateral involvement in 74.3%(84/113) of cases, and lymphocyte predominance($71{\pm}27%$) in differential count of WBC. 5) CEA levels in pleural fluid or plasma were over 10ng/ml in 60.6%(40/66), and ADA levels in pleural fluid were under 40U/L in 95%(57/60) of cases. 6) The patients were managed by various methods, but the efficacy of treatment was uncertain. 7) The mean survival time was $12.7{\pm}13.5$ weeks. Conclusion: It seems to be no effective treatment methods yet and the prognosis was very poor in this disease, so the objectives of diagnostic approaches and treatment methods should be directed to early diagnosis, treatment and prevention of curable disease. And we must make our best endeavors to lengthen the survival time and improve the quality of patients' life.

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The Clinical Usefulness of Spiral CT Angiography in the Diagnosis of Pulmonary Thromboembolism (폐색전증 진단에서 나선식 전산화 단층촬영 혈관조영술의 임상적 유용성)

  • Kim, Woo-Gyu;Lim, Byung-Sung;Kim, Mi-Young;Hwang, Hweung-Kon
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.5
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    • pp.669-680
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    • 1999
  • Background: Pulmonary thromboembolism(PTE) is a life threatening disease that needs early diagnosis. Spiral CT angiography depict thromboemboli in the central pulmonary vessels with greater than 90% sensitivity and specificity, which approaches the results of pulmonary angiography in the Prospective Investigation of Pulmonary Embolism Diagnosis(PIOPED) study. This study was performed to evaluate the findings and the diagnostic value(clinical utility) of the spiral CT angiography with 2D image(multiplanar reformation) and 3D images(Shaded surface display, Minimal intensity projection) in the pulmonary thromboembolism. Methods: We retrospectively analysed spiral CT angiography and pulmonary angiography, lung scan and clinical recordings of 20 patients who had PTE diagnosed by spiral CT angiography(n=19 cases) or pulmonary angiography(n=l case) from September 1997 to August 1998. Among 20 patients who had underwent spiral CT angiography, 14 patients could be performed lung perfusion scan at the same time. We analyzed the vascular and parenchymal change in spiral CT angiogram. Results: Anatomical distribution of PTE was as follows: 1) left lung(n= 103)

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Serum Immunoglobulin levels in Coal Worker's Pneumoconiosis Patients (진폐증 환자에서의 혈청 면역 글로불린의 변화)

  • Yoo, Kwang-Ha;Ahn, Chul-Min;Kim, Hyung-Joong;Kim, Young-Ho;Lee, Yong-Kyoo;Kim, Sung-Kyu;Lee, Won-Young
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.2
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    • pp.165-174
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    • 1999
  • Background: Coal-worker's pneumoconiosis(CWP) is radiologically divided into two major groups: simple pneumoconiosis (SP), in which small, rounded or irregular opacities smaller than 1cm are observed, and progressive massive fibrosis(PMF), which is characterized by opacities larger than 1cm. SP has a life expectancy equivalent to miners with no radiographic evidence of CWP, but PMF is associated with more obvious impairments of ventilatory capacity and premature death. But only minority of workers develop PMF when exposed to dust concentrations similar to those experienced by workers who develop only SP. In this study, immune status in patients with CWP were evaluated by measurement of the serum immunoglobulin levels between control, SP and PMF groups. Method: Coal workers selected for this study were emplyees of the Tae-Baek and Dong-Hae Hospital. All the patients were men of 45-76 years old and the mean duration of exposure to coal dust were 23.2 years. By X-ray examination, 51 patients were classified in SP, 59 in PMF category. The normal controls examined were 58 men of 26-70 years old. Serum Ig levels were estimated by using Nephelometer(Behring Nephelometer : Germany) and serum were collected 51 in SP, 49 in PMF and 57 cases in control group. Results: The levels of IgG were increased but the levels of IgM were decreased with increasing age in control groups. There were no statistical difference of immunoglobulin levels between smokers and nonsmokers in control groups. There were no statistical difference of immunoglobulin levels between Control, SP and PMF groups. Multiple regression analysis were undertaken to determine the statistical significance of the apparent trends and estimate the effects associated with age, smoking habit and radiological category of CWP. According to this analysis, the levels of IgG were decreased significantly in SP group and had decreasing tendancy, but not statistically significant in PMF group. Conclusion : From the observations described, CWP patients had decreased IgG concentration compared to control gorup. Therefore, there was some relation between CWP and immunoglobulin concentration.

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The Role and Significance of Biomarker for Plasma G-CSF in Patients with Primary Lung Cancer (원발성 폐암에서 혈장 과립구 자극인자의 암표지자로서의 역할과 의의)

  • Song, Jung Sub;Kim, So Young;Jo, Hyang Jeong;Lee, Kang Kyoo;Shin, Jeong Hyun;Shin, Seong Nam;Kim, Dong;Park, Seong Hoon;Lee, Young Jin;Ko, Chang Bo;Lee, Mi Kung;Choi, Soon Ho;Jeong, Jong Hoon;Park, Jung Hyun;Kim, Hui Jung;Kim, Hak Ryul;Jeong, Eun Taik;Yang, Sei Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.6
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    • pp.444-450
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    • 2009
  • Background: Biomarkers for cancer have several potential clinical uses, including the following: early cancer detection, monitoring for recurrence prognostication, and risk stratification. However, no biomarker has been shown to have adequate sensitivity and specificity. Many investigators have tried to validate biomarkers for the early detection and recurrence of lung cancer. To evaluate plasma G-CSF as such a biomarker, protein levels were measured and were found to correlate with the clinicopathological features of primary lung tumors. Methods: Between December 2006 and May 2008, 100 patients with histologically-validated primary lung cancer were enrolled into this study. To serve as controls, 127 healthy volunteers were enrolled into this study. Plasma G-CSF levels were measured in lung cancer patients using the sandwich ELISA system (R & D inc.) prior to treatment. Results: The mean plasma G-CSF levels were 12.2$\pm$0.3 pg/mL and 46.0$\pm$3.8 pg/mL (mean$\pm$SE) in the normal and in the cancer groups, respectively. In addition, plasma G-CSF levels were higher in patients with early lung cancer than in healthy volunteers (p<.001). Plasma G-CSF levels were higher in patients who were under 65 years old or smokers. Within the cancer group, plasma G-CSF levels were higher in patients with non small cell lung cancer than in patients with small cell lung cancer (p<.05). Overall, plasma G-CSF levels were shown to increase dependent upon the type of lung cancer diagnsosed. In the order from highest to lowest, the levels of plasma G-CSF tended to decrease in the following order: large cell carcinoma, squamous cell carcinoma, adenocarcinoma, and bronchioloalveolar carcinoma. Plasma G-CSF levels tended to be higher in patients with advanced TNM stage than in localized TNM stage (I, II

Definition of Tumor Volume Based on 18F-Fludeoxyglucose Positron Emission Tomography in Radiation Therapy for Liver Metastases: An Relational Analysis Study between Image Parameters and Image Segmentation Methods (간 전이 암 환자의 18F-FDG PET 기반 종양 영역 정의: 영상 인자와 자동 영상 분할 기법 간의 관계분석)

  • Kim, Heejin;Park, Seungwoo;Jung, Haijo;Kim, Mi-Sook;Yoo, Hyung Jun;Ji, Young Hoon;Yi, Chul-Young;Kim, Kum Bae
    • Progress in Medical Physics
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    • v.24 no.2
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    • pp.99-107
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    • 2013
  • The surgical resection was occurred mainly in liver metastasis before the development of radiation therapy techniques. Recently, Radiation therapy is increased gradually due to the development of radiation dose delivery techniques. 18F-FDG PET image showed better sensitivity and specificity in liver metastasis detection. This image modality is important in the radiation treatment with planning CT for tumor delineation. In this study, we applied automatic image segmentation methods on PET image of liver metastasis and examined the impact of image factors on these methods. We selected the patients who were received the radiation therapy and 18F-FDG PET/CT in Korea Cancer Center Hospital from 2009 to 2012. Then, three kinds of image segmentation methods had been applied; The relative threshold method, the Gradient method and the region growing method. Based on these results, we performed statistical analysis in two directions. 1. comparison of GTV and image segmentation results. 2. performance of regression analysis for relation between image factor affecting image segmentation techniques. The mean volume of GTV was $60.9{\pm}65.9$ cc and the $GTV_{40%}$ was $22.43{\pm}35.27$ cc, and the $GTV_{50%}$ was $10.11{\pm}17.92$ cc, the $GTV_{RG}$ was $32.89{\pm}36.8$4 cc, the $GTV_{GD}$ was $30.34{\pm}35.77$ cc, respectively. The most similar segmentation method with the GTV result was the region growing method. For the quantitative analysis of the image factors which influenced on the region growing method, we used the standardized coefficient ${\beta}$, factors affecting the region growing method show GTV, $TumorSUV_{MAX/MIN}$, $SUV_{max}$, TBR in order. The result of the region growing (automatic segmentation) method showed the most similar result with the CT based GTV and the region growing method was affected by image factors. If we define the tumor volume by the auto image segmentation method which reflect the PET image parameters, more accurate and consistent tumor contouring can be done. And we can irradiate the optimized radiation dose to the cancer, ultimately.

Selection of Vegetables and Fertigation Methods for Veranda Gardening (베란다 재배에 적합한 채소작물 및 관비방법 선발)

  • Moon, Ji-Hye;Lee, Sang-Gyu;Jang, Yoon-Ah;Lee, Woo-Moon;Lee, Ji-Weon;Kim, Seung-Yu;Park, Hyun-Jun
    • Journal of Bio-Environment Control
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    • v.16 no.4
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    • pp.314-321
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    • 2007
  • This study was conducted to select leaf vegetables suitable for cultivation in apartment verandas and simple and easy fertigation method for home gardening. In order to develop the convenient fertigation method, hydroponics, wick irrigation, and overhead irrigation methods were compared. For the wick irrigation, two types of nutrient sources were used; one was slow release fertilizers mixed with medium and the other one was nutrient solution filled in container located under pots. The growth of leafy lettuce, leaf mustard, and leaf beet was better in both of the wick irrigation methods rather than in overhead irrigation and hydroponics. The wick irrigation method is very easy, so that it is expected to bring a good result from the cultivating and managing point of view, if it brings with commercialized system along with slow release fertilizer. As a result of investigation of environment such as temperature, relative humidity, and irradiance level in apartment verandas in autumn the highest irradiance level during a day was just 48% and 35% in verandas facing south and feeing southeast, respectively, comparing to that in greenhouse. The light environment was investigated as a limiting factor for vegetable growing in verandas. Therefore, to select the vegetables showing good growth under low irradiance environment, nine leaf vegetables such as romaine lettuce, lent lettuce, head lettuce, endive, pak-choi, leaf mustard, garland chrysanthemum, leaf beet, and Chinese chive were grown under 0%, 50%, 70%, 90% shading. Among them, Chinese chive showed the best growth under low irradiance levels. Endive showed line growth reduction according to shading degree, however, even under 90% shading condition, it showed good growth. And then leafy lettuce, garland chrysanthemum, and pak-choi followed. Therefore, these results will be of help in selecting vegetables for veranda gardening with different light levels.

Effect of Asarum sieboldii Extracts on the Growth, Acid Production, Adhesion, and Insoluble Glucan Synthesis of Streptococcus mutans (세신 추출물의 Streptococcus mutans에 대한 성장, 산생성, 부착 및 비수용성 글루칸 합성억제에 미치는 영향)

  • Yu Hyeon Hee;Seo Se Jeong;Kim Yeon Hwa;Lee Heung Soo;Kim Kang Ju;Jeon Byung Hun;You Yong Ouk
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.17 no.3
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    • pp.666-671
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    • 2003
  • Dental caries are the most commonly occurring chronic diseases in the dental field. Because of increasing sugar consumption and extension of average human life, these diseases are widely found all over the world as the most typical cause for a person to lose a tooth. Therefore, the development of more effective, substantial and safe preventive agents against dental caries is strongly required. Streptococcus mutans is known as the causative bacterial playing the most important role informing plaque and it is being noticed as major causative bacteria of dental caries. The present study was designed to investigate the effect of Asarum sieboldii Miquel(Aristolochiaceae) extracts on the growth, acid production, adhesion, and insoluble glucan synthesis of Streptococcus mutans(S. mutans). Both methanol and aqueous extracts showed concentration dependent inhibitory activity against the growth and acid production of S. mutans, and produced significant inhibition at the concentration of 100, 1,000 and 2,000 μg/ml compared to the control group(p<0.05 - p<0.01). The extracts markedly inhibited S. mutans adherence to HA treated with saliva, and cell adherence was repressed by more than 50% at the concentration of 10 μg/ml and complete inhibition was observed at the concentration of 2,000 μg/ml. On the activity of glucosyltransferase which synthesizes water insoluble glucan from sucrose, methanol and aqueous extracts showed more than 70% inhibition over the concentration of 1,000 μg/ml. Hence, we conclude that Asarum sieboldii might be a candidate of anticaries agent.

Effect of LED mixed light conditions on the glucosinolate pathway in brassica rapa (배추 유묘의 글루코시놀레이트 합성 기작에 미치는 LED 혼합광의 효과)

  • Moon, Junghyun;Jeong, Mi Jeong;Lee, Soo In;Lee, Jun Gu;Hwang, Hyunseung;Yu, Jaewoong;Kim, Yong-Rok;Park, Se Won;Kim, Jin A
    • Journal of Plant Biotechnology
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    • v.42 no.3
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    • pp.245-256
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    • 2015
  • In the agricultural industries, LEDs are used as supplementary, as well as main lighting sources in closed cultivation systems. In cultivation using artificial light sources, various light qualities have been tried to supplement fluorescent lamps to promote plant growth and metabolism. Microarray analysis of Brassica rapa seedlings under blue and fluorescent mixed with blue light conditions identified changes in three genes of the glucosinolate pathway. This attracted attention as functional materials highly expressed 3.6-4.6 fold under latter condition. We selected four more genes of the glucosinolate pathway from the Brassica database and tested their expression changes under fluorescent light mixed with red, green, and blue, respectively. Some genes increased expression under red and blue mixed conditions. The Bra026058, Bra015379, and Bra021429; the orthologous genes of CYP79F1, ST5a, and FMOGS-OX1 in Arabidopsis, are highly expressed in Brassica rapa under fluorescent mixed with blue light conditions. Further, Bra029355, Bra034180, Bra024634, and Bra022448; the orthologous genes of MAM1, AOP3, UGT74B1, and BCAT4 in Arabidopsis, are highly expressed in Brassica rapa under fluorescent mixed with red light conditions. The various light conditions had unique effects on the varieties of Brassica, resulting in differences in glucosinolate synthesis. However, in some varieties, glucosinolate synthesis increased under mixed blue light conditions. These results will help to construct artificial light facilities, which increase functional crops production.

Analysis of Telomere Length and Telomerase Activity of Tissues in Korean Native Chicken (한국 재래닭의 주령별 각 조직의 텔로미어 함량과 텔로머레이스 활성도 분석)

  • Jung G.S.;Cho E.J.;Choi D.S.;Lee M.J.;Park C.;Jeon I.S.;Sohn S.H.
    • Korean Journal of Poultry Science
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    • v.33 no.2
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    • pp.97-103
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    • 2006
  • Telomeres are essential for chromosome stability and are related with cell senescence, apoptosis and cancer. Even though telomere length and telomerase activity have been studied extensively, very little is known to analyze the telomere dynamics in chicken cells. This study was carried out to analyze the telomere distribution and telomerase activity of Korean Native Chicken cells along with aging. The cells were collected from brain, heart, liver, kidney and germinal tissues during physiological stages. Telomere distribution was analyzed by Quantitative-Fluorescence in situ Hybridization (Q-FISH) techniques using the chicken telomeric DNA probe. Telomerase activity was performed by Telomeric Repeat Amplification Protocol (TRAP) assay. In results, the telomeres of chicken were found at the ends of all chromosomes with the interstitial telomeres on chromosomes 1, 2 and 3. The amount of telomeres on chicken cells was decreased along with aging in most tissues. Furthermore, the telomere quantity was significantly different among tissues. The relative amount of telomeres in proliferous cells such as testis cells had much more than those of liver, brain, heart, blood and kidney cells. The telomerase activity was down-regulated in cells of brain, heart and liver tissues. Whereas gonadal cells showed a constitutive activity of telomerase during all stage of life. In conclusions, the telomere quantity and telomerase activity in chicken are closely relate to cell proliferation and tissue specificity during developmental stages and aging. There is also closely correlated between the amounts of telomeric DNA and telomerase activity in chicken tissues.