• Journal of Gastric Cancer
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• v.15 no.4
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• pp.270-277
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• 2015

Purpose: Minimally invasive gastrectomy (MIG), including laparoscopic distal subtotal gastrectomy (LDG) and robotic distal subtotal gastrectomy (RDG), is performed for gastric cancer, and requires a learning period. However, there are few reports regarding MIG by a beginner surgeon trained in MIG for gastric cancer during surgical residency and fellowship. The aim of this study was to report our initial experience with MIG, LDG, and RDG by a trained beginner surgeon. Materials and Methods: Between January 2014 and February 2015, a total of 36 patients (20 LDGs and 16 RDGs) underwent MIG by a beginner surgeon during the learning period, and 13 underwent open distal subtotal gastrectomy (ODG) by an experienced surgeon in Bundang CHA Medical Center. Demographic characteristics, operative findings, and short-term outcomes were evaluated for the groups. Results: MIG was safely performed without open conversion in all patients and there was no mortality in either group. There was no significant difference between the groups in demographic factors except for body mass index. There were significant differences in extent of lymph node dissection (LND) (D2 LND: ODG 8.3% vs. MIG 55.6%, P=0.004) and mean operative time (ODG 178.8 minutes vs. MIG 254.7 minutes, P<0.001). The serial changes in postoperative hemoglobin level (P=0.464) and white blood cell count (P=0.644) did not show significant differences between the groups. There were no significant differences in morbidity. Conclusions: This study showed that the operative and short-term outcomes of MIG for gastric cancer by a trained beginner surgeon were comparable with those of ODG performed by an experienced surgeon.

• The Korean Journal of Zoology
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• v.33 no.3
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• pp.322-329
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• 1990

The effects of retinoic acid (RA) on the regenerating limbs of Korean newt (Hynobius leechii) larvae have been studied. Intraperitoneal injection of RA at 4 days post-amputation caused the proximalization of regenerate structures in the proximodistal (PD) axis of the limbs amputated through either the distal zeugopodium or the distal stylopodium. The mean level of proximalization (MLP) increased as a dose-dependent manner, and the MLP was also dependent on the level of amputation at a given dose of RA. At the dose of 150 $\mu$ g/g body wt., MLP's in either amputation level reached close to a peak value, and an increasing number of inhibition of regeneration or duplication in the transverse plane occurred at the dose of 200 $\mu$ g/ g body wt. and above. The changes induced by RA treatment suggest that positional values in the cells of the regenerating limbs have been modified in the three cardinal axes including PD and transverse axes in a graded mode. Furthermore, from the comparison of data in two different amputation levels, it can be speculated that the sensitivity of cells to RA effect along the PD axis might not be linear.

• Archives of Plastic Surgery
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• v.45 no.1
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• pp.62-68
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• 2018

Background Amputation is commonly performed for toe necrosis secondary to peripheral vascular diseases, such as diabetes mellitus. When amputating a necrotic toe, preservation of the bony structure is important for preventing the collapse of adjacent digits into the amputated space. However, in the popular terminal Syme's amputation technique, partial amputation of the distal phalanx could cause increased tension on the wound margin. Herein, we introduce a new way to resect sufficient bony structure while maintaining the normal length, based on a morphological analysis of the toes. Methods Unlike the pulp of the finger in the distal phalanx, the toe has abundant teardrop-shaped pulp tissue. The ratio of the vertical length to the longitudinal length in the distal phalanx was compared between the toes and fingers. Amputation was performed at the proximal interphalangeal joint level. Then, a mobilizable pulp flap was rotated $90^{\circ}$ cephalad to replace the distal soft tissue defect. This modified toe fillet flap was performed in 5 patients. Results The toe pulp was found to have a vertically oriented morphology compared to that of the fingers, enabling length preservation through cephalad rotation. All defects were successfully covered without marginal ischemia. Conclusions While conventional toe fillet flap coverage focuses on the principle of length preservation as the first priority, our modified method takes both wound healing and length into account. The fattiest part of the pulp is advanced to the toe tip, providing a cushioning effect and enough length to substitute for phalangeal bone loss. Our modified method led to satisfactory functional and aesthetic outcomes.

• Journal of Korean Neurosurgical Society
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• v.29 no.10
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• pp.1360-1364
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• 2000

This 26-year-old man gradually developed a disabling midbrain tremor involving both distal and proximal part of left upper arm. On neurologic examination, oculomotor palsy, and ataxia of the left arm were noted. Radiologic examination revealed a mass lesion on midbrain tegmentum. He was tentatively diagnosed as brain tumor (presumably germinoma) without stereotactic biopsy. Conventional radiation therapy was given for this lesion. Although there was improvement in the radiologic imaging, his midbrain tremor worsened and became untolerable. The authors performed MR-guided stereotactic Vim-thalamotomy. With macroelectrode stimulation and radiofequency lesioning, his resting, postural and action tremors were almost completely abolished in both distal and proximal part of left upper extremity. Authors consider that Vim thalamotomy is still an effective means of controlling midbrain tremor involving proximal upper limb.

• Journal of Gastric Cancer
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• v.24 no.3
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• pp.257-266
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• 2024

Purpose: We conducted a randomized prospective trial (KLASS-07 trial) to compare laparoscopy-assisted distal gastrectomy (LADG) and totally laparoscopic distal gastrectomy (TLDG) for gastric cancer. In this interim report, we describe short-term results in terms of morbidity and mortality. Methods and Methods: The sample size was 442 participants. At the time of the interim analysis, 314 patients were enrolled and randomized. After excluding patients who did not undergo planned surgeries, we performed a modified per-protocol analysis of 151 and 145 patients in the LADG and TLDG groups, respectively. Results: The baseline characteristics, including comorbidity status, did not differ between the LADG and TLDG groups. Blood loss was somewhat higher in the LADG group, but statistical significance was not attained (76.76±72.63 vs. 62.91±65.68 mL; P=0.087). Neither the required transfusion level nor the operation or reconstruction time differed between the 2 groups. The mini-laparotomy incision in the LADG group was significantly longer than the extended umbilical incision required for specimen removal in the TLDG group (4.79±0.82 vs. 3.89±0.83 cm; P<0.001). There were no between-group differences in the time to solid food intake, hospital stay, pain score, or complications within 30 days postoperatively. No mortality was observed in either group. Conclusions: Short-term morbidity and mortality rates did not differ between the LADG and TLDG groups. The KLASS-07 trial is currently underway.

• Applied Microscopy
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• v.14 no.2
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• pp.81-93
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• 1984

Structural differences in various divisions of the rabbit colon were investigated using light and scanning electron microscopy. For light microscopic study, various Portions of the colon from seven rabbits (2.5 kg body weight) were fixed in 10% neutral buffered formalin, and paraffin sections were stained with hematoxylin-eosin. Tissues for scanning electron microscopy were fixed in 1% glutaraldehyde-1.5% paraformaldehyde and postfixed in 1% $OsO_4$, dehydrated to 100% alcohol, transfered to isoamilacetate and dried by the critical point method. Subsequently, specimens were coated with gold and viewed with a JSM-35C scanning electron microscope. The colon displays a morphological diversity along its proximo-distal axis. Five regions can be discerned based on the macroscopic and microscopic characteristics. 1) The first segment immediately distal to the cecocolical junction possessing three teniae is approximately 5 cm ($4{\sim}6cm$) in length, and displays irregular folds of the mucosa oriented transversely similar to those of the cecum. 2) The second segment possessing three teniae is about 7 cm ($5{\sim}8cm$) in length, and is characterized by the papilla-like protrusions on the mucosal surface. 3) The third segment, possessing a single tenia is about 16 cm ($12{\sim}20cm$) in length, and also displays the papilla-like protrusions similar to the aforegoing segment. 4) Fusus coli, approximately 4 cm ($3{\sim}5cm$) in length, is free of teniae and exhibits longitudinal folds on the mucosal surface. These four portions together constitute the proximal colon. 5) The distal colon reaches a length of about 58 cm ($53{\sim}55cm$) and shows a pattern of surface irregularities with minor ridges on the mucosal folds.

• Journal of Nutrition and Health
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• v.39 no.2
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• pp.171-183
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• 2006

This study was conducted to examine dietary factors affecting bone status in the rural aged men. Quantitative ultrasound measurements (QUS) of bone, that may reflect certain architectural aspects of bone, have been shown to be associated with bone mineral density and fracture. Information of diet and anthropometry was collected in 164 aged men. Dietary intake data were obtained by 24-hour recall method. Measurements of the speed of sound (SOS, m/s), at distal radius, mid-tibia, phalanx, were performed using Omnisense 7000S analyzer (Sunlight Ltd., Tel Aviv, Israel). T-scores for bone SOS measurements at distal radius, mid-tibia and phalanx were 0.60, 0.03 and -0.42 respectively. The prevalence of osteopenia by use of the WHO criteria was 17.7% at the mid-tibia and 25.3% of the subjects at the distal radius. Age were negative association with bone SOS at three sites. Osteopenia group of radius were significantly lower in total foods and vegetable intakes than normal group. After adjusted for age, vegetable intakes were significantly and positively related to bone SOS at the radius. The bone SOS of the tibia were significantly and positively related to vegetable protein, iron, folate and vegetable intakes, but negatively related to fat intakes. Multiple regression analysis showed that bone SOS of tibia was positively associated with folate intakes. Vegetable intakes were positively associated with the bone SOS at three sites. These results indicate that the consumption of vegetables, sources of folate, may have a effect on bone status of men.

• Archives of Reconstructive Microsurgery
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• v.9 no.2
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• pp.186-189
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• 2000

A case of distal lower leg replantation, in an elderly patient, was successfully performed after retrieval of the amputated limb from 3 hours of immersion in seawater. Due to the patient's age, bony union was delayed and functional nerve recovery was unsatisfactory. After massive saline irrigation of the amputated part, employing a catheter through the main artery, as well as, prophylactic antibiotics to prevent infection by Aeromonas, there were no postoperative complications. Despite the issue of age, immersion of an amputated part into seawater is not a contraindication of replantation.

• Animal Systematics, Evolution and Diversity
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• v.7 no.1
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• pp.45-54
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• 1991

An anthessiid copepod ; Anthessius atrinae n.sp., is described based on the specimens recorved in the mantle cavity of Atrina pectinata (Linn) taken from Korean waters. This is distinguished from congeners by formula II, I, 5 on distal segment of exopod of the fourth leg, three terminal claws on distal segment of the second antenna , and the shape of caudal ramus.

• Journal of Chest Surgery
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• v.30 no.8
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• pp.833-837
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• 1997

Congenital tracheal stenosis is very rare, but it leads to life threatening obstruction in infancy and childhood. Recently, we experienced two cases of congenital tracheal stenosis, involving half of the distal trachea. We adopted slide tracheoplasty procedure Proposed by Peter Goldstraw Tracheoplasty was performed by dividing the stenosis at midpoint, incising the proximal and distal narrow segments vertically on opposite anterior and posterior surfaces, and sliding these together. On case 1, the patient':s now doing well. On case 2, the patient succumbed due to anastomotic disruption at postoperative ay 4.