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.
The Journal of Korean Society for Radiation Therapy
/
v.16
no.2
/
pp.43-61
/
2004
Purpose : For qualify improvement in radiotherapy, it is important to set up and evaluate equipment (linac) accurately. In addition, technicians are needed to be fully aware of the equipment's detailed quality and its manual. Therefore, the result of ATP is evaluated and introduced, in order that the technicians are skilled by participating in quality assurance (QA) and understanding the quality of the equipment before clinical use. Method and Material : QA for LINAC 21EX (Varian, US) was done with suppliers its procedure was divided into radiation survey, mechanical test, radiation isocenter test, bean performance, dosimetry, and enhanced dynamic wedge and using X-omat film (Kodak), multidata, densitometer, and electrometer. QA of MLC (Millennium, 120 leaf) attached to LINAC and EPID (Portal vision) were done separately. Result : The leakage dose by survey meter was below the tolerance. In mechanical test, collimater, gantry, and couch rotation were less than 1mm, and the angles were ${\pm}0.1^{\circ}$ for digital and ${\pm}0.5^{\circ}$ for mechanical. The alignment test of the light field and crosshair were evaluated less than 1mm. The (a)symmetrical jaw field was less than ${\pm}0.5mm$. The radiation isocenter test using X-mat film was less than 1mm. The consistency of light field and radiation field was less than ${\pm}0.1mm$. PDD for photon energy was less than ${\pm}1\%$ and for electron energy of $90\%,\;80\%,\;50\%,\;and\;30\%$ were evaluated within the tolerance. Flatness for photon and electron energy was evaluated $2.3\%$ (tolerance $3\%$) and $3\%$ (tolerance $4.5\%$), respectively, and symmetry was $0.45\%$ (tolerance $2\%$) and $0.3\%$ (tolerance $2\%$), respectively. Dosimetry test for short term, MU setting, rep rate, and dose rate accuracy of photon and electron energy was within the tolerance depending on energy, MU, and gantry angle. Conclusion : Accuracy and safety for clinical use of Clinac 21EX was verified through customer acceptance procedure and the quality of the equipment was found out. These can reduce the difficulties in using the equipment. Furthermore, it is useful for clinically treatment of patients by technicians' active participations.
Journal of the Korean Society of Marine Environment & Safety
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v.21
no.1
/
pp.9-17
/
2015
In order to elucidate the current state of marine pollution of heavy metals around major shipyards in Korea, seawater samples were collected at eleven sampling stations and four control stations around 4 major shipyards located in the southeastern coast of Korea in summer 2010, and 6 kinds of metals such as copper(Cu), zinc(Zn), iron(Fe), cadmium(Cd), lead(Pb) and mercury(Hg) in seawater samples were analyzed. The analyses of heavy metals in seawater showed that the mean Cu concentrations in seawater around 4 major shipyards were in the range of $0.817{\sim}1.638{\mu}g/L$ which were lower than Korean environmental standards of $20{\mu}g/L$ for the protection of human health(PHH) and of $3{\mu}g/L$ for short-term protection of marine ecosystem(SPME) but higher than Cu concentration at control station by a factor of up to 2.75. The mean Zn concentrations were in the range of $0.228{\sim}0.567{\mu}g/L$ which were lower than Korean environmental standards of $100{\mu}g/L$ for PHH and $34{\mu}g/L$ for SPME but higher than Zn concentration at control station by a factor of up to 5.91. The mean Fe concentrations were in the range of $3.332{\sim}7.410{\mu}g/L$ which were higher than Fe concentration at control station by a factor of up to 6.75. The mean Cd concentrations were in the range of $0.013{\sim}0.028{\mu}g/L$ which were lower than Korean environmental standards of $10{\mu}g/L$ for PHH and $19{\mu}g/L$ for SPME but higher than Cd concentration at control station by a factor of up to 2.33. The mean Pb concentrations were in the range of $0.007{\sim}0.126{\mu}g/L$ which were lower than Korean environmental standards of $50{\mu}g/L$ for PHH and $7.6{\mu}g/L$ for SPME. The mean Hg concentrations were in the range of $0.002{\sim}0.004{\mu}g/L$ which were lower than Korean environmental standards of $0.5{\mu}g/L$ for PHH and $1.8{\mu}g/L$ for SPME. Although the concentrations of metals such as Cu, Zn and Fe which were used in shipbuilding works were lower than Korean environmental standards for PHH and SPME, the fact that the concentrations of Cu, Zn and Fe at sampling stations around major shipyards were higher than those at control stations implies that the works in shipyards had some effects on marine water quality around shipyards. Therefore, marine environment management such as the prevention and control of the discharge of various pollutants from shipyards is required on national level.
Purpose: We tested a sample of nuclear medicine workers at Korean healthcare institutions for internal contamination with radioactive isotopes, measuring concentrations and evaluating doses of individual exposure. Materials and Methods: The detection and measurement was performed on urine samples collected from 25 nuclear medicine workers at three large hospitals located in Seoul. Urine samples were collected once a week, 100~200 mL samples were gathered up to 6~10 times weekly. A high-purity germanium detector was used to measure gamma radiations in urine samples for the presence of radioactive isotopes. Based on the detection results, we estimated the amounts of intake and committed effective doses using IMBA software. In cases where committed effective doses could not be adequately evaluated with IMBA software, we estimated individual committed effective doses for radionuclides with a very short half life such as $^{99m}Tc$ and $^{123}I$, using the methods recommended by International Atomic Energy Agency. Results: Radionuclides detected through the analysis of urine samples included $^{99m}Tc$, $^{123}I$, $^{131}I$ and $^{201}Tl$, as well as $^{18}F$, a nuclide used in Positron Emission Tomography examinations. The committed effective doses, calculated based on the radionuclide concentrations in urine samples, ranged from 0 to 5 mSv, but were, in the majority of cases, less than 1 mSv. The committed effective dose exceeded 1 mSv in three of the samples, and all three were workers directly handling radioactive sources. No nurses were found to have a committed effective dose in excess of 1 mSv. Conclusions: To improve the accuracy of results, it may be necessary to conduct a long-term study, performed over a time span wide enough to allow the clear determination of the influence of seasonal factors. A larger sample should also help increase the reliability of results. However, as most Korean nuclear medicine workers are currently not necessary to monitored routinely for internal contamination with radionuclides. Notwithstanding, a continuous effort is recommended to reduce any unnecessary exposure to radioactive substances, even if in inconsequential amounts, by regularly surveying workplace environments and frequently monitoring atmospheric concentrations of radionuclides.
Purpose : Although oseltamivir is widely used for treatment of influenza, few clinical studies of its efficacy and resistance have been performed in Korea. We evaluated the safety, side effects, and efficacy of oseltamivir treatment in Korean pediatric patients. Methods : We analyzed 321 children diagnosed with influenza at Busan St. Mary's Medical Center, Korea, between January 2008 and June 2008 (first study period) and November 2008 and January 2009 (second study period). Patients were divided into two groups: those receiving oseltamivir treatment for 5 days and those receiving only symptomatic treatment. We investigated clinical symptoms, side effects, and resistance to oseltamivir. We also identified influenza strains and evaluated resistance to oseltamivir using an influenza virus culture. Results : One hundred eighty-six patients were assigned to the treatment group, and 135 were assigned to the control group. The treatment group showed shorter admission duration (4.4 days) compared with controls (5.0 days) (P =0.000) and had fewer lower respiratory tract complications compared with controls (P <0.05). No significant statistical difference in the virus antigenic type was observed between the groups. In the first study period, virus culture showed influenza B (41.7% vs. 49.6%), A/H3N2 (7.9% vs. 8.4%), and A/H1N1 (9.4% vs. 6.5%). In the second study period, only A/H1N1 (55.3% vs. 50.0%) was isolated, except for one case of A (H3N2) in the treatment group. No differences in short- and long-term side effects, including neuropsychologic side effects, were noted between groups. There was no resistance to oseltamivir before or after treatment in the first study period. Conclusion : Based on our results, we suggest that osetalmivir therapy in pediatric patients is effective.
To evaluate the efficacy and safety of red ginseng on women's health-related quality of life (QOL) and sexual function. A randomized, double-blind, placebo-controlled, crossover clinical study was performed. The main efficacy was measured using the Female Sexual Function Index (FSFl) and the 36-Item Short-Form Health Survey (SF-36). Twenty-four healthy, married women aged 30-45 years with FSFl scores below 25 were randomly divided into two groups: the red-ginseng group (N=12) and the placebo group (N=12). During the first six-week period (Study 1), each group was given red ginseng or placebo twice a day. Before the start of the second six-week period (Study 2), a crossover design was chosen with a two-week break (washout period). Interchanging the two groups after the washout period, red ginseng and placebo were given to each group. The outcomes were measured before and after each six-week period. Overall, 23 participants completed the study. In Study 1, the changes relative to the baseline in the FSFl total score were 22.50% and 22.99% for red ginseng and placebo, respectively. In Study 2, the relative changes were 8.14% for red ginseng and 6.29% for placebo. The results showed a greater improving trend in Study 1 with respect to all of the participants' sexual functions, but no significant difference was found between the groups (P=0.9567). After taking red ginseng, all the participants exhibited an improving trend in the desire domain of FSFl, but no significant difference was shown. In the measurement of SF-36, no significant difference was likewise shown. After taking red ginseng, though, all the participants exhibited an improving trend in the physical functioning (PF) domain of SF-36, with no significant difference. Moreover, there was no significant adverse event related to red ginseng. The QOL and sexual function of the study participants in the red-ginseng group were mostly improved, but no statistically significant effect of red ginseng was shown. It is supposed that this result was partly due to the affirmative impression of red ginseng in Korea. Thus, it is anticipated that a long-term clinical trial will show a significant effect of red ginseng on the QOL and sexual function.
Journal of the Korean Society of Marine Environment & Safety
/
v.25
no.7
/
pp.867-873
/
2019
As of August 2019, there were 3,823 vessels under 30 tons that could be included in the category of small vessels; these account for 42.5 % of the 9,001 registered vessels in Korea. The problem is that many small vessel seafarers face many problems such as an board communication disconnection, difficulties in communication in maritime license interviews, or education related to maritime training using a large number of nonstandard terms, which are derived from foreign languages; this is leading to a decline the job skills of small vessel seafarers. Therefore, in this study, we closely analyzed the terminology of small vessel seafarers and proposed a standardization plan. In the terminology analysis, the preliminary terms of the maritime license interview and the high-frequency terms of the small vessel educational textbook were identified and the corresponding nonstandard terms were examined. Based on a survey, an expert meeting was held and incorrect Japanese notation, English notation, and the standard language for key terms were presented to analyze which questionnaire was most familiar. The ratio of the use of standard words is relatively high in the case of nautical terms, however, the wrong Japanese notation is used more for engine terms; the analysis results by age and tonnage also generally use the Japanese notation and the use frequency of English notation was determined to be low. Based on this, short- and long-term plans for the use of standard words by small vessel seafarers were proposed, including the production of a standard language dictionary for terms used by these seafarers, a promotion of the importance of using standard terms, active education through educational institutions, and the systematic preparation and implementation of Korean-language education for foreign sailors.
Journal of the Korean Society of Marine Environment & Safety
/
v.28
no.6
/
pp.882-889
/
2022
In this study, to understand the factors influencing the flow change the Tsushima Warm Current (TWC), the correlation between the volume transport the TWC, El Niño Southern Oscillation (ENSO), and Pacific Decadal Oscillation (PDO) was analyzed. A calculation of the monthly volume transport of TWC for 25 years (1993-2018) revealed that the seasonal fluctuation cycle was the largest in summer and smallest in winter. Power spectrum analysis to determine the periodicity of the TWC volume transport, Oceanic Niño Undex (ONI), and PDO indicated that the TWC volume transport peaked at a one year cycle, but ONI and PDO showed no clear cycle. Further, to understand the correlation between the TWC transport volume and ONI and PDO, the coherence estimation method was used for analysis. The coherence of ONI and PDO had a high mutual contribution in long-period fluctuations of three years or more but had low mutual contribution in short-period fluctuations within one year. However, the coherence value between the two factors of the TWC volume transport and PDO was 0.7 in the 0.8-1.2 year cycle, which had a high mutual contribution. Meanwhile, the TWC volume transport and PDO have an inverse correlation between period I (1993-2002) and period III (2010-2018). When the TWC maximum transport volume (2.2 Sv or more) was high, the PDO index showed a negative value below -1.0, and the PDO index showed a positive value when the TWC maximum transport volume was (below 2.2 Sv). Therefore, using long-term PDO index data, changes in the TWC transport volume and water temperature in the East Sea coastal area could be predicted.
Kang, Dong Won;Lee, Kwang Sup;Kim, Young Ryun;Choi, Ki-young;Kim, Chang-joon
Journal of the Korean Society of Marine Environment & Safety
/
v.28
no.2
/
pp.212-223
/
2022
For the remediation and restoration of contaminated sediment at the West Sea-Byeong dumping site, dredged materials was dumped in 2013, 2014, 2016, and 2017. The physicochemical properties and benthic fauna in surface sediments of the capping area (5 stations) and natural recovery area (2 stations) were analyzed annually from 2014 to 2020 to evaluate the capping effect of the dredged materials. The natural recovery area had a finer sediment with a mean particle size of 5.91-7.64 Φ, while the sediment in the capping area consisted of coarse-grained particles with a mean particle size of 1.47-3.01 Φ owing to the capping effect of dredged materials. Considering that the contents of organic matters (COD, TOC, and TN) and heavy metals in the capping area are approximately 50 % lower (p<0.05) than that in the natural recovery area, it is judged that there is a capping effect of dredged materials. As a result of analyzing macrobenthic assemblages, the number of species and ecological indices of the capping area were significantly lower than that of the natural recovery area (p<0.05). The number of species and ecological indices at the capping area were increased for the first four years after the capping in 2013 and 2014 and then tended to decrease thereafter. It is presumed that opportunistic species, which have rapid growth and short lifetime, appeared dominantly during the initial phase of capping, and the additory capping in 2016 and 2017 caused re-disturbance in the habitat environment. In the natural recovery and capping areas, Azti's Marine Biotic Index (AMBI) was evaluated as a fine healthy status because it maintained the level of 2nd grades (Good), whereas Benthic Pollution Index (BPI) remained at the 1st and 2nd grade. Therefore, capping of dredged materials for remediation of contaminated sediment in the dumping site has the effect of reducing the pollution level. However, in terms of the benthic ecosystem, it is recommended that the recovery trend should be monitored long-term. Additionally, it is necessary to introduce an adaptive management strategy when expanding the project to remediate the contaminated sediment at the dumping area in the future.
The principal objective of the present study was to survey the demands of an education program for evaluations of the efficacy of health functional foods. A questionnaire was developed and sent to 2,225 members of the Biofood Network Center. A total of 101 (4.6%) individuals responded, 54.5% of the respondents were male and 45.5% were female; the respondents' occupations (in order of prevalence) were as follows: company worker (48.5%)>researcher (27.7%)>student (13.9%)>professor (5.0%)>pharmacist (2%), and dietitian (2%). The businesses in which the respondents worked were (again in order of prevalence) as follows: research & development (64.4%)>marketing (11.9%)>consultation and education (5.9%)>manufacturing and others (17.9%). 41.6% of the respondents reported experience in businesses relevant to KFDA approval for functional ingredients and health functional foods. The results showed that 63.4% of the respondents had previously been educated about functional foods; the types of education program reported were (in order of prevalence): 'overview and acts of health functional food' (n=49)>'standards and specification for health functional food' (n=41)>'efficacy evaluation-human study' (n=24)>'safety evaluation' (n=21)>'efficacy evaluation-in vivo study' (n=13)>and 'others' (n=10). Respondents preferred off-line education programs (62.4%) to on-line programs (22.8%). The preferred duration of an educational program was '$2{\sim}3$ days: total $14{\sim}24$ hours' (30.7%); thus, short-term programs were favored. The primary requirements of a program, from the perspective of the learner, were as follows (scored on a 7-point scale); 'efficacy evaluation and case study-human study' (5.80 points)>'standards and specification for health functional food' (5.72 points)>safety evaluation' (5.7 points)>'overview and acts of health functional food' (5.67 points) and 'efficacy evaluation methods of health functional food by efficacy (intensive)' (5.67 points). Preference for functionality was as follows; 'body weight & body fat' (21.8%), 'immune function' (18.8%) > 'blood glucose' (10.9%). In summary, the educational demand for 'efficacy evaluation and case study' was highest among the curriculum options provided, and with regard to functionality, 'body weight & body fat', 'immune function' and 'skin care' were considered most important by respondents. These results differed among respondents with different jobs and duties, and this suggests that customized education programs for health functional food should be developed.
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