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Differentiation of Recurrent Rectal Cancer and Postoperative Fibrosis: Preliminary Report by Proton MR Spectroscopy (재발성 직장암과 수술 후 섬유화의 감별 진단: 수소 MRS에 의한 예비보고)

  • Jeon Yong Sun;Cho Soon Gu;Choi Sun Keun;Kim Won Hong;Kim Mi Young;Suh Chang Hae
    • Investigative Magnetic Resonance Imaging
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    • v.8 no.1
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    • pp.24-31
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    • 2004
  • Purpose : To know the differences of proton MR spectroscopic features between recurrent rectal cancer and fibrosis in post-operative period, and to evaluate the possibility to discriminate recurrent rectal cancer from post-operative fibrosis by analysis of proton MR spectra. Materials and Methods : We evaluated the proton MR spectra from 25 soft tissue masses in perirectal area that developed in post-operative period after operation for the resection of rectal cancer. Our series included 11 cases of recurrent rectal cancer and 14 of fibrotic mass. All cases of recurrent rectal cancer and post-operative fibrosis were confirmed by biopsy. We evaluated the spectra with an attention to the differences of pattern of the curves between recurrent rectal cancer and post-operative fibrosis. The ratio of peak area of all peaks at 1.6-4.1ppm to lipid (0.9-1.6ppm) [P (1.6-4.1ppm/P (0.9-1.6ppm)] was calculated in recurrent rectal cancer and post-operative fibrosis groups, and compared the results between these groups. We also evaluated the sensitivity and specificity for discriminating recurrent rectal cancer from post-operative fibrosis by analysis of $^1H-MRS$. Results : Proton MR spectra of post-operative fibrosis showed significantly diminished amount of lipids compared with that of recurrent rectal cancer. The ratio of P (1.6-4.1ppm)/P (0.9-1.6ppm) in post-operative fibrosis was much higher than that of recurrent rectal cancer with statistical significance (p < .05) due to decreased peak area of lipids. Mean (standard deviations of P (1.6-4.1ppm)/P (0.9-1.6ppm) in post-operative fibrosis and recurrent rectal cancer group were $2.71{\pm}1.48\;and\;0.29{\pm}0.11$, respectively. With a cut-off value of 0.6 for discriminating recurrent rectal cancer from post-operative fibrosis, both the sensitivity and specificity were $100\%$ (11/11, and 14/14). Conclusion : Recurrent rectal cancer and post-operative fibrosis can be distinguished from each other by analysis of proton MR spectroscopic features, and $^1H-MRS$ can be a new method for differential diagnosis between recurrent rectal cancer and post-operative fibrosis.

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The Results of using the Cabrol Technique for Aortic Root Replacement (대동맥 근부치환술에 대한 Cabrol 술식의 성적)

  • Kim, Jeong-Won;Lee, Jong-Tae;Cho, Joon-Yong;Kim, Kyu-Tae;Kim, Gun-Jik
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.573-579
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    • 2008
  • Background: Composite valve graft replacement is currently the treatment of choice for a wide variety of the lesions of aortic root disease. The purpose of this study was to explore the results of aortic root replacement after using the Cabrol technique over a 13-year period at our institution, and we analyzed the results to help surgeons make better decisions when repairing aortic root disease. Material and Method: Between January 1994 and December 2006, twenty-five patients underwent a Cabrol technique operation at our institution. The mean patient age was $43.7{\pm}14.1$ years old (range: $6{\sim}65$ years) and the male and female ratio was 21:4 (84% : 16%). The patients' follow-up was 100% complete, and the mean follow-up period was $60.7{\pm}50.4$ (range:$1{\sim}162$) months. Annuloaortic ectasia (n=18) was the most frequent cause of aortic disease in this series, followed by aortic dissection (n=7). The mean cardiopulmonary bypass time was $177.2{\pm}44.9$ minutes and the mean aortic cross clamping time was $123.4{\pm}34.1$ minutes. Nine patients were checked with MDCT (Multidetector computed tomography) for evaluating a well functioning secondary graft and the coronary anastomosis site. Result: The early mortality rate was 4% (1 of 25 patients). A significant stenosis, kinking or occlusion of the secondary graft was detected by MDCT in 4 patients. The overall survival rate was 88%. Conclusion: The Cabrol technique demonstrated a significant incidence of long-term complications such as secondary graft stenosis or obstruction. It could be used when the modified Bentall technique is not feasible.

Site Monitoring System of Earthquake, Fault and Slope for Nuclear Power Plant Sites (원자력발전소의 부지감시시스템의 운영과 활용)

  • Park, Donghee;Cho, Sung-il;Lee, Yong Hee;Choi, Weon Hack;Lee, Dong Hun;Kim, Hak-sung
    • Economic and Environmental Geology
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    • v.51 no.2
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    • pp.185-201
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    • 2018
  • Nuclear power plants(NPP) are constructed and operated to ensure safety against natural disasters and man-made disasters in all processes including site selection, site survey, design, construction, and operation. This paper will introduce a series of efforts conducted in Korea Hydro and Nuclear Power Co. Ltd., to assure the safety of nuclear power plant against earthquakes and other natural hazards. In particular, the present status of the earthquake, fault, and slope safety monitoring system for nuclear power plants is introduced. A earthquake observatory network for the NPP sites has been built up for nuclear safety and providing adequate seismic design standards for NPP sites by monitoring seismicity in and around NPPs since 1999. The Eupcheon Fault Monitoring System, composed of a strainmeter, seismometer, creepmeter, Global Positioning System, and groundwater meter, was installed to assess the safety of the Wolsung Nuclear Power Plant against earthquakes by monitoring the short- and long-term behavioral characteristics of the Eupcheon fault. Through the analysis of measured data, it was verified that the Eupcheon fault is a relatively stable fault that is not affected by earthquakes occurring around the southeastern part of the Korean peninsula. In addition, it was confirmed that the fault monitoring system could be very useful for seismic safety analysis and earthquake prediction study on the fault. K-SLOPE System for systematic slope monitoring was successfully developed for monitoring of the slope at nuclear power plants. Several kinds of monitoring devices including an inclinometer, tiltmeter, tension-wire, and precipitation gauge were installed on the NPP slope. A macro deformation analysis using terrestrial LiDAR (Light Detection And Ranging) was performed for overall slope deformation evaluation.

A Study on the Competition Strategy for Private Super Market against Super Super Market (슈퍼슈퍼마켓(SSM)에 대한 개인 슈퍼마켓의 경쟁전략에 관한 연구)

  • Yoo, Seung-Woo;Lee, Sang-Youn
    • The Journal of Industrial Distribution & Business
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    • v.2 no.2
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    • pp.39-45
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    • 2011
  • The Korean distribution industry is gearing up for an endless competition. Greeting low growth era, less competitive parties will be challanged seriously for their survival. But for large discount stores, they have shown steady annual growth for years. However, because of the saturation for numbers of stores, the difficulty of gaining new sites, and the changes in the consumer's consumption behavior caused by the recession, now they are seeking for a new customers-based business formats. Accordingly, a large corporate comopanies made supermarkets which are belonged to affiliated companies of large corporate comopanies. They based on the strong buying power, focused on SSM(Super Super Market) ave been aggressively develop nationwide multi-stores. The point is that these stores are threatening at small and medium-sized, community-based private supermarkets. Private supermarkets and retailers, who are using existing old operation systems and their dilapidated facilities, are losing a competitive edge in business. Recent the social effects of large series of corporate supermarkets for traditional markets has been very controversial, and commercial media, academia, and industry associated with it have been held many seminars and public hearings. This may slow down the speed in accordance with the regulations, but will not be the crucial alternative. The reason for this recent surge of enterprise-class SSM up, one of the reasons is a stagnation in their offline discount mart, so they are finding new growth areas. Already in the form of large supermarkets across the country got most of the geographical centre point and is saturated with stages. Targeting small businesses that do not cover discount Mart, in order to expand business in the form of SSM is urgent. By contrast, private supermarkets are going to lose their competitiveness. The vulnerability of individual supermarkets, one of the vulnerabilities is price which economies of scale can not be realized so they are purchasing a small amount of products and difficult to get a quantity discount. The lack of organization and collaboration, and education which is not practical, caused the absencer of service-oriented situations. As a first solution, making specialty shops which are handling agricultures, fruits and vegetables and manufactured goods is recommended. Second, private supermarkets franchisees join the organization for the organization and collaboration is recomaned. It can be meet the scale of economy and can be formed a alternative business formats to a government. Third, the education is needed as a good service will get consumer's awareness. In addition, a psychological stores operating is also one way to stimulate consumer sentiment as SSM can't operate. Japan already has a better conditions of their lives through small chain expression. This study includes the vulnerabilities of private supermarkets, and suggests a competitiveness reinforcement strategies.

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Two stage reconstruction of bilateral alveolar cleft using Y-shaped anterior based tongue flap and iliac bone graft (Y-형 전방 기저 설 피판과 장골 이식을 이용한 양측성 치조열의 이단계 재건술)

  • Lee, Jong-Ho;Kim, Myung-Jin;Kang, Jin-Han;Kang, Na-Ra;Lee, Jong-Hwan;Choi, Won-Jae;Choi, Jin-Young
    • Korean Journal of Cleft Lip And Palate
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    • v.3 no.1
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    • pp.23-31
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    • 2000
  • Objective: When an alveolar cleft is too large to close with adjacent mucobuccal flaps or large secondary fistula following a primary bilateral palatoplasty exists, a one-stage procedure for bone grafting becomes challenging. In such a case, we used the tongue flap to repair the fistula and cleft alveolus in the first stage, and bone grafting to the cleft defect was performed in the second stage several months later. The purpose of this paper is to report our experiences with the use of an anteriorly-based Y-shaped tongue flap to fit the palatal and labial alveolar defects and the ultimate result of the bone graft. Patients: A series of 14 patients underwent surgery of this type from January 1994 to December 1998.The average age of the patients was 15.8 years old (range: 5 to 28 years old). The mean period of follow-up following the 2nd stage bone raft operation was 45.9 months (range: 9 to 68 months). In nine of the 14 cases, the long-fork type of a Yshaped tongue flap was used for extended coverage of the labial side alveolar defects with the palatal fistula in the remaining cases the short-forked design was used. Results: All cases demonstrated a good clinical result after the initial repair of cleft alveolus and palatal fistula. There was no fistula recurrence, although Partial necrosis of distal margin in long-forked tongue flap was occurred in one case. Furthermore, the bone graft, which was performed an average of 8 months after the tongue flap repair, was always successful. Occasionally, the transferred tongue tissue was bulging and interfering with the hygienic care of nearby teeth; however, these problems were able to be solved with proper contour-pasty performed afterwards. No donor site complications such as sensory disturbance, change in taste, limitations in tongue movement, normal speech impairments or tongue disfigurement were encountered. Conclusion: This two-stage reconstruction of a bilateral cleft alveolus using a Y-shaped tongue flap and iliac bone graft was very successful. It may be indicated for a bilateral cleft alveolus patient where the direct closure of the cleft defect with adjacent tissue or the buccal flap is not easy due to scarred fibrotic mucosa and/or accompanied residual palatal fistula.

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Laparoscopic Gastric Surgery in Early Gastric Cancer: the Analysis of Early 25 Cases (조기 위암에서 복강경하 위 절제술: 초기 25예에 대한 경험)

  • Sung Jung Youp;Park Tae Jin;Jeong Chi Young;Joo Young Tae;Lee Young Joon;Hong Soon Chan;Ha Woo Song
    • Journal of Gastric Cancer
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    • v.4 no.4
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    • pp.230-234
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    • 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)

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Current Status and Future Perspective of PET (PET 이용 현황 및 전망)

  • Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.1
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    • pp.1-7
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    • 2002
  • Positron Emission Tomography (PET) is a nuclear medicine imaging modality that consists of systemic administration to a subject of a radiopharmaceutical labeled with a positron-emitting radionuclide. Following administration, its distribution in the organ or structure under study can be assessed as a function of time and space by (1) defecting the annihilation radiation resulting from the interaction of the positrons with matter, and (2) reconstructing the distribution of the radioactivity from a series of that used in computed tomography (CT). The nuclides most generally exhibit chemical properties that render them particularly desirable in physiological studies. The radionuclides most widely used in PET are F-18, C-11, O-15 and N-13. Regarding to the number of the current PET Centers worldwide (based on ICP data), more than 300 PET Centers were in operation in 2000. The use of PET technology grew rapidly compared to that in 1992 and 1996, particularly in the USA, which demonstrates a three-fold rise in PET installations. In 2001, 194 PET Centers were operating in the USA. In 1994, two clinical and research-oriented PET Centers at Seoul National University Hospital and Samsung Medical Center, was established as the first dedicated PET and Cyclotron machines in Korea, followed by two more PET facilities at the Korea Cancer Center Hospital, Ajou Medical Center, Yonsei University Medical Center, National Cancer Center and established their PET Center. Catholic Medical School and Pusan National University Hospital have finalized a plan to install PET machine in 2002, which results in total of nine PET Centers in Korea. Considering annual trends of PET application in four major PET centers in Korea in Asan Medical Center recent six years (from 1995 to 2000), a total of 11,564 patients have been studied every year and the number of PET studies has shown steep growth year upon year. We had 1,020 PET patients in 1995. This number increased to 1,196, 1,756, 2,379, 3,015 and 4,414 in 1996,1997,1998,1999 and 2000, respectively. The application in cardiac disorders is minimal, and among various neuropsychiatric diseases, patients with epilepsy or dementia can benefit from PET studios. Recently, we investigated brain mapping and neuroreceptor works. PET is not a key application for evaluation of the cardiac patients in Korea because of the relatively low incidence of cardiac disease and less costly procedures such as SPECT can now be performed. The changes in the application of PET studios indicate that, initially, brain PET occupied almost 60% in 1995, followed by a gradual decrease in brain application. However, overall PET use in the diagnosis and management of patients with cancer was up to 63% in 2000. The current medicare coverage policy in the USA is very important because reimbursement policy is critical for the promotion of PET. In May 1995, the Health Care Financing Administration (HCFA) began covering the PET perfusion study using Rubidium-82, evaluation of a solitary pulmonary nodule and pathologically proven non-small cell lung cancer. As of July 1999, Medicare's coverage policy expanded to include additional indications: evaluation of recurrent colorectal cancer with a rising CEA level, staging of lymphoma and detection of recurrent or metastatic melanoma. In December of 2001, National Coverage decided to expand Medicare reimbursement for broad use in 6 cancers: lung, colorecctal, lymphoma, melanoma, head and neck, and esophageal cancers; for determining revascularization in heart diseases; and for identifying epilepsy patients. In addition, PET coverage is expected to further expand to diseases affecting women, such as breast, ovarian, uterine and vaginal cancers as well as diseases like prostate cancer and Alzheimer's disease.

Fate of Heavy Metals in Activated Sludge: Sorption of Heavy Metal ions by Nocardia amarae

  • Kim, Dong-wook
    • Proceedings of the Korean Environmental Sciences Society Conference
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    • 1998.10a
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    • pp.2-4
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    • 1998
  • Proliferation of Nocardia amarae cells in activated sludge has often been associated with the generation of nuisance foams. Despite intense research activities in recent years to examine the causes and control of Nocardia foaming in activated sludge, the foaming continued to persist throughout the activated sludge treatment plants in United States. In addition to causing various operational problems to treatment processes, the presence of Nocardia may have secondary effects on the fate of heavy metals that are not well known. For example, for treatment plants facing more stringent metal removal requirements, potential metal removal by Nocardia cells in foaming activated sludge would be a welcome secondary effect. In contrast, with new viosolid disposal regulations in place (Code o( Federal Regulation No. 503), higher concentration of metals in biosolids from foaming activated sludge could create management problems. The goal of this research was to investigate the metal sorption property of Nocardia amarae cells grown in batch reactors and in chemostat reactors. Specific surface area and metal sorption characteristics of N. amarae cells harvested at various growth stages were compared. Three metals examined in this study were copper, cadmium and nickel. Nocardia amarae strain (SRWTP isolate) used in this study was obtained from the University of California at Berkeley. The pure culture was grown in 4L batch reactor containing mineral salt medium with sodium acetate as the sole carbon source. In order to quantify the sorption of heavy metal ions to N amarae cell surfaces, cells from the batch reactor were harvested, washed, and suspended in 30mL centrifuge tubes. Metal sorption studies were conducted at pH 7.0 and ionlc strength of 10-2M. The sorption Isotherm showed that the cells harvested from the stationary and endogenous growth phase exhibited significantly higher metal sorption capacity than the cells from the exponential phase. The sequence of preferential uptake of metals by N. amarae cells was Cu>Cd>Ni. The specific surFace area of Nocardia cells was determined by a dye adsorption method. N.amarae cells growing at ewponential phase had significantly less specific surface area than that of stationary phase, indicating that the lower metal sorption capacity of Nocardia cells growing at exponential phase may be due to the lower specific surface area. The growth conditions of Nocardia cells in continuous culture affect their cell surface properties, thereby governing the adsorption capacity of heavy metal. The comparison of dye sorption isotherms for Nocardia cells growing at various growth rates revealed that the cell surface area increased with increasing sludge age, indicating that the cell surface area is highly dependent on the steady-state growth rate. The highest specific surface area of 199m21g was obtained from N.amarae cell harvested at 0.33 day-1 of growth rate. This result suggests that growth condition not only alters the structure of Nocardia cell wall but also affects the surface area, thus yielding more binding sites of metal removal. After reaching the steady-state condition at dilution rate, metal adsorption isotherms were used to determine the equilibrium distributions of metals between aqueous and Nocardia cell surfaces. The metal sorption capacity of Nocardia biomass harvested from 0.33 day-1 of growth rate was significantly higher than that of cells harvested from 0.5- and 1-day-1 operation, indicatng that N.amarae cells with a lower growth rate have higher sorpion capacity. This result was in close agreement with the trend observed from the batch study. To evaluate the effect of Nocardia cells on the metal binding capacity of activated sludge, specific surface area and metal sorption capacity of the mixture of Nocardia pure cultures and activated sludge biomass were determined by a series of batch experiments. The higher levels of Nocardia cells in the Nocardia-activated sludge samples resulted in the higher specific surface area, explaining the higher metal sorption sites by the mixed luquor samples containing greater amounts on Nocardia cells. The effect of Nocardia cells on the metal sorption capacity of activated sludge was evaluated by spiking an activated sludge sample with various amounts of pre culture Nocardia cells. The results of the Langmuir isotherm model fitted to the metal sorption by various mixtures of Nocardia and activated sludge indicated that the mixture containing higher Nocardia levels had higher metal adsorption capacity than the mixture containing lower Nocardia levels. At Nocardia levels above 100mg/g VSS, the metal sorption capacity of activate sludge increased proportionally with the amount of Noeardia cells present in the mixed liquor, indicating that the presence of Nocardia may increase the viosorption capacity of activated sludge.

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Forecasting Hourly Demand of City Gas in Korea (국내 도시가스의 시간대별 수요 예측)

  • Han, Jung-Hee;Lee, Geun-Cheol
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.2
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    • pp.87-95
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    • 2016
  • This study examined the characteristics of the hourly demand of city gas in Korea and proposed multiple regression models to obtain precise estimates of the hourly demand of city gas. Forecasting the hourly demand of city gas with accuracy is essential in terms of safety and cost. If underestimated, the pipeline pressure needs to be increased sharply to meet the demand, when safety matters. In the opposite case, unnecessary inventory and operation costs are incurred. Data analysis showed that the hourly demand of city gas has a very high autocorrelation and that the 24-hour demand pattern of a day follows the previous 24-hour demand pattern of the same day. That is, there is a weekly cycle pattern. In addition, some conditions that temperature affects the hourly demand level were found. That is, the absolute value of the correlation coefficient between the hourly demand and temperature is about 0.853 on average, while the absolute value of the correlation coefficient on a specific day improves to 0.861 at worst and 0.965 at best. Based on this analysis, this paper proposes a multiple regression model incorporating the hourly demand ahead of 24 hours and the hourly demand ahead of 168 hours, and another multiple regression model with temperature as an additional independent variable. To show the performance of the proposed models, computational experiments were carried out using real data of the domestic city gas demand from 2009 to 2013. The test results showed that the first regression model exhibits a forecasting accuracy of MAPE (Mean Absolute Percentage Error) around 4.5% over the past five years from 2009 to 2013, while the second regression model exhibits 5.13% of MAPE for the same period.

A Study on Collection and Usage of Panel Data on On-board Job Taking and Separation of Korean Seafarers (한국선원의 승선과 이직에 대한 패널자료 구축과 활용방안)

  • Park, Yong-An
    • Journal of Korea Port Economic Association
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    • v.32 no.4
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    • pp.149-163
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    • 2016
  • Seafarers are an essential resource in maritime industries, which provide navigation skills, vessel maneuvering skills and fishing skills in the fishery industry. They also work as a driving force in pilotage, port operation, vessel traffic service, and marine safety. Other areas in maritime services, which rely on seafarer include safety management of ships, supervisory activities, and maritime accident assessment. In these ways, Korean seafarers have contributed to the growth of Korean economy. However, there have been issues of high separation rate, shortage of supply, multi-nationality, multiplicity of culture caused by employment of foreign seafarers, and aging. The present paper finds that maritime officers and fishery officers demonstrate differences in the statistics of on-board job taking and separation: the separation rate of fishery officers is higher than that of maritime officers. The existing data and statistics by the Korea Seafarer's Welfare & Employment Center could be improved by changing its structure from time series to panel data. The Korea Seafarer's Welfare & Employment Center is the ideal institution for collecting the panel data, as it has already accumulated and published relevant statistics regarding seafarer. The basic design method of the panel data is to adopt and improve it by including the information on ratings of maritime and fishery industries, ranks in a ship, personal information, family life, and career goal. Panel data are useful in short- and long-term forecasts of supply of Korean seafarers; demand evaluation of education, training, and reeducation of the seafarers; demographical dynamic analysis on Korean seafarers; inducement policy of long-term on board job taking in harmony with man-power demands in marine industries such as pilotage service; implementation of job attractiveness policy on Korean seafarers; and employment stabilization of Korean seafarers.