• Journal of Gastric Cancer
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• 제13권1호
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• pp.44-50
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• 2013

Purpose: Laparoscopic gastrectomy has been adopted for the treatment of gastric cancer, and despite the technical difficulties, totally laparoscopic distal gastrectomy has been considered less invasive than laparoscopy-assisted distal gastrectomy. Although there have been many reports regarding the feasibility and safety of totally laparoscopic distal gastrectomy at large volume centers, few reports have been conducted at low-volume centers. The purpose of this study is to try to assess the feasibility and safety of totally laparoscopic distal gastrectomy at a low volume center through the analysis of short-term outcomes of totally laparoscopic distal gastrectomy compared with laparoscopy-assisted distal gastrectomy. Materials and Methods: The clinical data and short-term surgical outcomes of 35 patients who had undergone laparoscopy-assisted distal gastrectomy between April 2007 and March 2010, and 37 patients who underwent totally laparoscopic distal gastrectomy between April 2010 and August 2012 were retrospectively reviewed. Results: There was no significant difference in the demographic and clinical data. However the reconstruction method and extent of lymphadenectomy showed statistically significant differences. Operation time and estimated blood loss did not show significant differences. Surgical and medical complications did not show significant differences but postoperative courses including time-to-first oral intake and postoperative hospital stay were significantly increased. Conclusions: Our study shows that totally laparoscopic distal gastrectomy is technically feasible at a low volume center. Therefore, totally laparoscopic distal gastrectomy can be considered as one of the surgical treatment for early gastric cancer. However the possibility that totally laparoscopic distal gastrectomy may have less benefit should also be considered.

• 대한한방내과학회지
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• 제37권3호
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• pp.495-507
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• 2016

Objectives: This study was designed to investigate the effects of Jwa Kum-Whan (JKW) on reflux esophagitis in rats.Methods: Forty rats were divided into five groups: a sham group (with no medication and only treated with ventrotoby); a group with reflux esophagitis (RE); a pantoprazole group (treated with 30 mg/kg pantoprazole per day for two weeks); a JKW280 group (treated with 280 mg/kg JKW per day for two weeks); and a JKW560 group (treated with 560 mg/kg JKW per day for 2 weeks). All rats fasted for 24 hrs and then were induced with RE by the oral administration of indomethacin and by a pylorus and forestomach ligation operation. After 8 hrs, the rats were sacrificed. We measured body weight, gastric juice pH, gastric volume, antioxidant activity, and cytokine and made a histologic examination of the esophagus and the stomach.Results: The weights of the rats in each group were not significantly different. The gastric juice pH significantly increased in the JKW560 group and the pantoprazole group compared with the RE group. Gastric volume significantly decreased in the JKW560 group compared with the RE group and the pantoprazole group. SOD activities significantly increased in the JKW280 and JKW560 groups compared with the RE group. Catalase activities significantly increased in the pantoprazole group and the JKW560 group compared with the RE group. TNF-α significantly decreased in the JKW280 and JKW560 groups compared with the RE group. IL-6 significantly decreased in the pantoprazole group and the JKW280 and JKW560 groups compared with the RE group. Histologic examination of the esophagus and the stomach showed significant improvements in the pantoprazole, JKW280, and JKW560 groups compared with the RE group.Conclusion: Based on these results, it is concluded that JKW can prevent reflux esophagitis.

• Journal of Gastric Cancer
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• 제10권4호
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• pp.241-246
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• 2010

Purpose: Laparoscopy-assisted gastrectomy (LAG) has become a technically feasible and safe procedure for early gastric cancer treatment. LAG is being increasingly performed in many centers; however, there have been few reports regarding LAG at low-volume centers. The aim of this study was to report our early experience with LAG in patients with gastric cancer at a low-volume center. Materials and Methods: The clinicopathologic data and surgical outcomes of 39 patients who underwent LAG for gastric cancer between April 2007 and March 2010 were retrospectively reviewed. Results: The mean age was 68.3 years. Thirty-one patients had medical co-morbidities. The mean patient ASA score was 2.0. Among the 39 patients, 4 patients underwent total gastrectomy and 35 patients underwent distal gastrectomy. The mean blood loss was 145.4 ml and the mean operative time was 259.4 minutes. The mean time-to-first flatus, first oral intake, and the postoperative hospital stay was 2.8, 3.1, and 9.3 days, respectively. The 30-day mortality rate was 0%. Postoperative complications developed in 9 patients, as follows: anastomotic leakage, 1; wound infection, 1; gastric stasis, 2; postoperative ileus, 1; pneumonia, 1; cerebral infarction, 1; chronic renal failure, 1; and postoperative psychosis, 1. Conclusions: LAG is technically feasible and can be performed safely at a low-volume center, but an experienced surgical team and careful patient selection are necessary. Furthermore, for early mastery of the learning curve for LAG, surgeons need education and training in addition to an accumulation of cases.

• Journal of Gastric Cancer
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• 제10권4호
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• pp.234-240
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• 2010

Purpose: Most gastric cancer patients undergo operations at large tertiary hospitals in Korea. However, some patients are treated at low volume hospitals. We investigated patient outcomes after gastric surgery at a secondary hospital and compared with outcomes of large volume centers. Materials and Methods: We included 184 patients who underwent gastric surgery for gastric cancer at our hospital from January 2003 to December 2008. We conducted a retrospective study and evaluated the clinicopathological characteristics, clinical outcomes and survival rate of patients. Results: Mean age was 61.7 years old. Male to female ratio was 2.2 : 1. Proportion of early gastric cancer was 38.6% and that of advanced gastric cancer was 61.4%. The 5 year overall survival rate of 184 patients was 66.3%. The overall survival rate was significantly lower for people over 62 years old. The morbidity rate and mortality at our hospital were 10.3% and 0.5%, respectively. Conclusions: The overall survival rate, morbidity and mortality were similar to those of the previous reports from Korea. Treatment of gastric cancer at a secondary hospital is feasible and safe. Standardization of operations and management of gastric cancer patients of the Korean Gastric Cancer Association is the most important factor to achieve these outcomes.

• Journal of Gastric Cancer
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• 제17권3호
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• pp.204-211
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• 2017

Purpose: Recently, a nomogram predicting overall survival after gastric resection was developed and externally validated in Korea and Japan. However, this gastric cancer nomogram is derived from large-volume centers, and the applicability of the nomogram in smaller centers must be proven. The purpose of this study is to externally validate the gastric cancer nomogram using a dataset from a medium-volume center in Korea. Materials and Methods: We retrospectively analyzed 610 patients who underwent radical gastrectomy for gastric cancer from August 1, 2005 to December 31, 2011. Age, sex, number of metastatic lymph nodes (LNs), number of examined LNs, depth of invasion, and location of the tumor were investigated as variables for validation of the nomogram. Both discrimination and calibration of the nomogram were evaluated. Results: The discrimination was evaluated using Harrell's C-index. The Harrell's C-index was 0.83 and the discrimination of the gastric cancer nomogram was appropriate. Regarding calibration, the 95% confidence interval of predicted survival appeared to be on the ideal reference line except in the poorest survival group. However, we observed a tendency for actual survival to be constantly higher than predicted survival in this cohort. Conclusions: Although the discrimination power was good, actual survival was slightly higher than that predicted by the nomogram. This phenomenon might be explained by elongated life span in the recent patient cohort due to advances in adjuvant chemotherapy and improved nutritional status. Future gastric cancer nomograms should consider elongated life span with the passage of time.

• 대한한의학원전학회지
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• 제13권2호
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• pp.147-147
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• 2000

For the healthy body, Ying Qi(營氣) and Wei Qi(衛氣) in Jing Maei(經脈) correspond to change of the four seasong and the Five elements at the natural world, and their operation are each other closely connected with regular order. It it is violated this order, it brings about confusion of functional activities of Qi(氣機) and it has a effect upon the five regions of the heart, the lungs, the intestines and stomach(腸胃), the limbs, the head so each differently symptoms come out, this is given a name to wu luan(五亂). this volume are described symptoms and law of cure of wu luan(五亂) therefore this is so called wu luan(五亂). this volume is divided three chapters according to contents, what can be acquired are summarized so follows: 1. chapter deals with symtematic order of functional activities of qi(氣機) 2. chaper deals with what confusion of functional activities of qi(氣機) bring out disease of wu luan(五亂) 3 chapter deals with needle-steadying technique(刺法) of curing wu luan(五亂).

• 대한한의학원전학회지
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• 제13권2호
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• pp.148-154
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• 2000

For the healthy body, Ying Qi(營氣) and Wei Qi(衛氣) in Jing Maei(經脈) correspond to change of the four season and the Five elements at the natural world, and their operation are each other closely connected with regular order. It it is violated this order, it brings about confusion of functional activities of qi(氣機) and it has a effect upon the five regions of the heart, the lungs, the intestines and stomach(腸胃), the limbs, the head so each differently symptoms come out, this is given a name to wu luan(五亂). this volume are described symptoms and law of cure of wu luan(五亂) therefore this is so called wu luan(五亂). this volume is divided three chapters according to contents, what can be acquired are summarized so follows: 1. chapter deals with systematic order of functional activities of qi(氣機) 2. chapter deals with what confusion of functional activities of qi(氣機) bring out disease of wu luan(五亂) 3 chapter deals with needle-steadying technique(刺法) of curing wu luan(五亂).

• The Korean Journal of Physiology
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• 제11권2호
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• pp.67-71
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• 1977

This study was undertaken to investigate the effect of cingulate cortical ablation upon gastric secretion and its components in rats. 23 male rats were divided into the cingulate(N=9) and the operated control(N= 14) groups. Cingulate cortex was ablated through a slit-shaped opening(1 mm in width, 5 mm in length) which was made symmetrically on both sides of, and parallel to, the sagittal suture by removing a bone flap from frontal bone on each side. In the operated control group, the surgical procedure was ended by the removal of the bone flap. Under light ether anesthesia, experimental animals were placed in a restraining jacket of fine mesh wire and gastric juice was collected for 5 hours via a canula which had been inserted through the anterior abdominal wall into the antral portion of the lumen of the stomach. Volume of the gastric juice was measured, and total acid output and free acid output were titrated with 0.04 N NaOH solution by using phenolphthalein and Topfer's reagent at indicator, and chloride ion output was estimated by means of chloridometer. Results obtained were that volume, total acid output, free acid output and chloride ion output of the gastric juice were higher significantly in the cingulate group than in the operated control group. It is inferred from the above results that the cingulate cortex exerts a fascilitatory influence upon gastric secretion and acid output in rats.

• 대한전기학회:학술대회논문집
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• 대한전기학회 2004년도 하계학술대회 논문집 C
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• pp.2137-2139
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• 2004

Cancer cell lysis at pulsed DC is realized using micromachined electrodes. In this research, quantitative analyses are performed on cell lysis results. The cell volume increasing at the pulses applied are analyzed in different medium conditions on osmotic pressure and conductivity, and the cell lysis procedures are studied in detail experimentally. Phosphate buffered saline (PBS) is used as the medium. To change the conductivity of PBS, NaCl concentration of PBS is adjusted, and inositol is used with PBS to control the effects of the osmotic pressure to cell lysis performance.

• Journal of International Society for Simulation Surgery
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• 제1권1호
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• pp.41-44
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• 2014

The aim of this report is showing the case that we could give exact navigation of perigastric vessels for gastrectomy with 3D CTA. A 74-year-old male patient visited hospital with gastric cancer. Early gastric cancer, type IIb was found at stomach antrum great curvature side. Before surgery, he underwent 3D CT angiography. 3D volume rendering images and MIP images were made by post processing. He had replaced Lt. hepatic artery arising from Lt. gastric artery. Surgeon could get patient's specific vascular anatomy before surgery including surgically relevant anatomical distance and direction and could finish gastrectomy within 4 hours and just 53ml blood loss.