• Asian Pacific Journal of Cancer Prevention
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• v.17 no.4
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• pp.1909-1915
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• 2016

Background: The purpose of this study was to determine the benefit of tertiary cytoreductive surgery (TC) for secondary recurrent epithelial ovarian cancer (EOC), focusing on whether optimal cytoreduction has an impact on disease-free survival, and whether certain patient characteristics could identify ideal candidates for TC. Materials and Methods: Retrospective analysis of secondary recurrent EOC patients undergoing TC at three Turkish tertiary institutions from May 1997 to July 2014 was performed. All patients had previously received primary cytoreduction followed by intravenous platinum-based chemotherapy and secondary cytoreduction for first recurrence. Clinical and pathological data were obtained from the patients' medical records. Survival analysis was caried out using the Kaplan Meier method. Actuarial curves were compared by the two tailed Logrank test with a statistical significance level of 0.05. Results: Median age of the patients was 49.6 years (range, 30-67) and thirty-eight (72%) had stage III-IV disease at initial diagnosis. Twenty six (49%) had optimal and 27 (51%) suboptimal cytoreduction during tertiary debulking surgery. Optimal initial cytoreduction, time to first recurrence, optimal secondary cytoreduction, time interval between secondary cytoreduction and secondary recurrence, size of recurrence, disease status at last follow-up were found to be significant risk factors to predict optimal TC. Optimal cytoreduction in initial and tertiary surgery and serum CA-125 level prior to TC were independent prognostic factors on univariate analysis. Conclusions: Our results and a literature review clearly showed that maximal surgical effort should be made in TC, since patients undergoing optimal TC have a better survival. Thus, patients with secondary recurrent EOC in whom optimal cytoreduction can be achieved should be actively selected.

• Clinical and Experimental Pediatrics
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• v.49 no.7
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• pp.726-731
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• 2006

Purpose : We reported previously that intramuscular ketamine with adjunctive midazolam is more effective than ketamine alone in pediatric procedural sedation, but with limited satisfactory sedation by suboptimal ketamine dose. The optimal dose of intramuscular ketamine in children has never been studied in Korea. In this study, we investigated the effectiveness and adverse events of ketamine 4mg/kg with adjunctive midazolam in pediatric laceration repair. Methods : From Jan. 2005 to July 2005, we enrolled 60 children, aged 3 months-7 years, who needed laceration repair under sedation. After verbal consent from parents, patients were randomly assigned to KMA group(IM ketamine 4 mg/kg＋atropine 0.01 mg/kg＋intramuscular midazolam 0.05 mg/kg) or KA group(without midazolam). We compared both groups with the induction time, recovery time, total sedation time, efficacy of sedation, adverse effects, and the satisfaction score of treating physicians. Results : Potentially confounding variables, age, weight, injury site and anxiety score, were similar between groups. The induction time, recovery time and total sedation time were not different statistically. In KMA group, 90.9 percent of patients showed satisfactory sedation compared to 66.7 percent of KA group(P=0.02) and the occurrence rate of significant adverse effect was 0.0 percent and 37.0 percent respectively. Conclusion : We found adjunctive midazolam with ketamine doses of 4 mg/kg IM produced more effective, satisfactory sedation and less adverse effect than without midazolam in pediatric laceration repair. The emergence phenomenon(agitation during recovery) only occurred in 9 KA group patients. In spite of adverse effect, all patients recovered, were discharged and there were no reported delayed events.

• Journal of the Korean Society of Food Science and Nutrition
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• v.34 no.4
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• pp.466-475
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• 2005

Docosahexaenoic acid (22:6n-3, DHA) is highly enriched in membrane of brain and retina, and plays an important role in maintaining an optimal function of the central nervous system. We investigated the effect of n-3 fatty acid deficiency on rat brain, retina and liver fatty acyl composition at two different ages (3 wks and 15 wks) under DHA deficient condition. Rat pups born to dams fed a diet with $3.1\%$ of total fatty acids as $\alpha-linolenic$ acid (LNA) were fed using an artificial rearing system either an n-3 deficient (n-3 Def) or n-3 adequate (n-3 Adq) diet. Both diets contained $17.1\%$ linoleic acid (LA) but the n-3 Adq diet also contained $3.1\%$ LNA. Rats consuming the n-3 Def diet showed a lower brain $(50\%\;in\;13\;wks\;and\;70\%\;in\;15\;wks,\;p<0.05)$ and retinal $(50\%\;in\;13\;wks\;and\;63\%\;in\;15\;wks,\;p<0.05)$ DHA than those on the n-3 Adq diet, which was largely compensated for by an increase in docosapentaenoic acid (22:5n-6, DPAn-6). In the liver of the n-3 Def group, the percentage of DHA decreased by $97\%$ at 3 wks of age with an apparent increase in DPAn-6 relative to the n-3 Adq group (p<0.05), while there was a $65\%$ lower liver DHA in n-3 Def group at 15 wks of age than the n-3 Adq group (p<0.05). Liver arachidonic acid (20:4n-6, AA) was increased at 3 wks of age but decreased at 15 wks of age in the n-3 Def group compared with n-3 Adq group (p<0.05). In conclusion, the replacement of DHA by DPAn-6 in brain and retina fatty acid composition may be related to the suboptimal function in spatial learning, memory and visual acuity. This artificial rearing method presents a first generation model for n-3 deficiency that is similar to the case of human nutrition that commonly employed two generation model.

• Journal of Chest Surgery
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• v.37 no.1
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• pp.11-18
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• 2004

Background: We tested the effect of indomethacine and total spinal anesthesia on the improvement of placental flow during cardiopulmonary bypass on fetal lamb. Material and Method: Twenty fetuses at 120 to 150 days of gestation were subjected to bypass via trans-sternal approach with a 12 G pulmonary arterial cannula and 14 to 18 F venous cannula for 30 minutes. All ewes received general anesthesia with ketamine. In all the fetuses, no anesthetic agents were used except muscle relaxant. Ten served as a control group in which placenta was worked as an oxygenator during bypass (Control group). The remainder worked as an experimental group in which pretreatment with indomethacine and total spinal anesthesia was performed before bypass with the same extracorporeal circulation technique as control group (Experimental group). Observations were made every 10 minutes during a 30-minute bypass and 30-minute post bypass period. Result: Weights of the fetuses ranged from 2.2 to 5.2 kg. In Control group, means of arterial pressure decreased from 44.7 to 14.4 mmHg and means of Pa$CO_2$ increased from 61.9 to 129.6 mmHg at each time points during bypass. Flow rate was suboptimal (74.3 to 97.0 $m\ell$/kg/min) during bypass. All hearts fibrillated immediately after the discontinuation of bypass. On the contrary, in Experimental group, means of arterial pressure reamined higher (45.8 to 30 mmHg) during bypass (p<0.05). Means of Pa$CO_2$ were less ranging from 59.8 to 79.4 mmHg during bypass (P<0.05). Flow rates were higher (78.8 to 120.2 $m\ell$/kg/min) during bypass (p<0.05). There were slower deterioration of cardiac function after cessation of bypass. Conclusion: In this study, we demonstrated that the placental flow was increased during fetal cardiopulmonary bypass in the group pretreated with indomethacine and total spinal anesthesia. However, further studies with modifications of the bypass including a creation of more concise bypass circuit, and a use of axial pump are mandatory for the clinical application.

• Journal of Chest Surgery
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• v.35 no.3
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• pp.177-181
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• 2002

Background: Follow-up studies have shown that although outcomes have improved substantially over time, results of the Fontan operation and its modifications remain suboptimal. In this study, we reviewed our experience with the extracardiac conduit Fontan operation, with a focus early and midterm change of internal diameter of PTFE conduit. Material and Method: Between April 1997 and July 2000 were reviewed. Twelve patients (M:6, F:6, mean age 42.04 $\pm$ 12.43months, mean body weight 13.80$\pm$ 1.94kg) underwent extracardiac conduit Fontan operation with expanded PTFE graft. Mean cardiopulmonary bypass time was 109.7$\pm$26.99minute and mean operation time was 455$\pm$89.51minute. Intraoperative fenestration was performed in 10 patients. The aortic cross clamping was not performed in all patients. Result: There was no early deaths and no postoperative dysrhythmia. Postoperative protein losing enteropathy and prolonged pleural effusion occurred in 1(8.3%) and 4 patients(33.3%). Conduit patency was evaluated by magnetic resonance imaging studies. A 9.84$\pm$3.84% mean reduction in conduit internal diameter and there was no statistical correlation between the change of internal diameter of conduit and the postoperative duration after partial correlation analysis(r=0.019, p=0.955). Conclusion: These results demonstrate that the extracardiac conduit Fontan operation provies good early and midterm results and may reduce the prevalence of late arrhythmia. And there is no correlation between the change of internal diameter of conduit and the postoperative duration after extracardiac conduit Fontan operation with the expanded PTFE graft conduit.

• Journal of Mushroom
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• v.17 no.4
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• pp.224-229
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• 2019

The two most common mushroom species grown in Korea are pearl oyster mushroom (Pleurotus ostreatus) and king oyster mushroom (P. eryngii). In recent years, the production of king oyster mushroom greatly increased due to the automation of the cultivation facilities, and it became a major export mushroom owing to its excellent shelf life. However, the increase in the production of king oyster mushroom led to a decline in its market price; thus, necessitating the development of new mushroom species that could replace king oyster mushroom, to diversify the mushroom market for the benefit of both, the producers and the consumers. The Mushroom division at the National Institute of Horticultural & Herbal Science (NIHHS) reported the development of a new interspecific hybrid between P. ferulae and P. tuoliensis, referred to as 'Creamy.' Two parental strains KMCC00430 (Bisan2ho, P. ferulae) and KMCC00461 (P. tuoliensis) were selected based on the results of genetic resource analysis, and their monokaryons were collected. About 1,000 Mon-Mon crosses were performed and 73 of them were selected. Following repeated cultivation tests and strain analyses, we selected strain 7773, which had a bright creamy pileus and a thick straight stipe, and named it 'Creamy.' Optimum temperature for mycelial growth of Creamy was 25-30℃, and that for fruiting body growth was 16℃. The pileus, which had a brighter creamy color, was small in size with a diameter of 61.2 mm. Although it was cultivated in suboptimal conditions, such as low temperature and high CO₂ concentration, Creamy was characterized by its straight and smooth stipe. Field production tests and further analyses indicated that the yield of Creamy was 5% higher than that of Baekhwang. It is expected that Creamy, the new interspecific hybrid with a bright creamy pileus and a pleasant flavor, will help create new opportunities for mushroom farmers and diversify the mushroom market.

• Korean Journal of Environmental Biology
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• v.37 no.4
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• pp.652-663
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• 2019

The purpose of this study was to conduct ecological health assessments by using the fish communities in the Manchurian trout habitat. Sampling was conducted twice in July and September 2018. In the survey, 1,119 individuals belonging to 16 species and seven families were collected. The dominant species by number was Rhynchocypris kumgangensis and the subdominant species was Zacco koreanus. Korean endemic species represented 73.33% at Geybang Stream and 76.92% at Naerin Stream. Community analysis revealed that the structure of the fish community was unstable by the dominance index 0.63 (±0.09)-0.97 (±0.01), the diversity index 1.63 (±0.23)-0.33 (±0.09), the evenness index 0.79 (±0.06)-0.24 (±0.07) and the richness index 0.67 (±0.14)-1.80(±0.16). According to the analysis of the tolerance guilds, the total individual number of sensitive species was higher than the intermediate and tolerant species. The insectivore species accounted for 65.09-98.56% of the total trophic guilds, which was the highest observed. The value of the QHEI (Qualitative habitat evaluation index) in the Brachymystax lenok tsinlingensis habitat was 119.5 (±0.5)-153.5 (±0.5), indicating an optimal-suboptimal condition. The FAI (Fish assessment index) stream health value was A to B in the study sites. Correlation analysis with FAI and various factors was conducted and a high correlation in QHEI, Brachymystax lenok tsinlingensis individuals, species, individuals, diversity, richness, sensitive species, carnivorous species, insectivorous species, and omnivorous species was found. The similarity analysis was divided into three groups from A to C, based on 56.9%.

• Journal of Hospice and Palliative Care
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• v.7 no.2
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• pp.238-247
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• 2004

Purpose: Pain management is often needlessly suboptimal. Health care professionals are seldom trained in pain management, may not realize the importance of pain management or recognize that a patient is in pain, and may fear prescribing opioid medications. Noting that one of the problems related to health care professionals is poor assessment of pain, we studied a trend of pain severity and satisfaction with pain controls after using TTS-fentanyl in order to determine whether a regular pain assessment was effective for controlling cancer pain. Methods: We assessed the pain as a $5^{th}$ vital sign after using TTS-fentanyl in 471 hospitalized cancer patients during 4 days. The data were collected from September, 2003 to December, 2003. Pain severity was assessed by using a numeric pain intensity scale($0{\sim}10$) by ongoing pain assessment. Results: Pain assessment as a $5^{th}$ vital sign had led to reduce patient's pain scores. High degrees of satisfaction scores in both patients and doctors with TTS-fentanyl were observed. They were also negatively correlated with the pain severity. Conclusion: Regular pain assessment was effective in the management of cancer pain.

• Journal of Intelligence and Information Systems
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• v.16 no.2
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• pp.129-141
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• 2010

An Internet shopping mall for clothing operates a warehouse for packing and shipping products to fulfill its orders. All the products in the warehouse are put into the boxes of same brands and the boxes are stored in a row on shelves equiped in the warehouse. To make picking and managing easy, boxes of the same brands are located side by side on the shelves. When new products arrive to the warehouse for storage, the products of a brand are put into boxes and those boxes are located adjacent to the boxes of the same brand. If there is not enough space for the new coming boxes, however, some boxes of other brands should be moved away and then the new coming boxes are located adjacent in the resultant vacant spaces. We want to minimize the movement of the existing boxes of other brands to another places on the shelves during the warehousing of new coming boxes, while all the boxes of the same brand are kept side by side on the shelves. Firstly, we define the adjacency of boxes by looking the shelves as an one dimensional series of spaces to store boxes, i.e. cells, tagging the series of cells by a series of numbers starting from one, and considering any two boxes stored in the cells to be adjacent to each other if their cell numbers are continuous from one number to the other number. After that, we tried to formulate the problem into an integer programming model to obtain an optimal solution. An integer programming formulation and Branch-and-Bound technique for this problem may not be tractable because it would take too long time to solve the problem considering the number of the cells or boxes in the warehouse and the computing power of the Internet shopping mall. As an alternative approach, we designed a fast heuristic method for this reallocation problem by focusing on just the unused spaces-empty cells-on the shelves, which results in an assignment problem model. In this approach, the new coming boxes are assigned to each empty cells and then those boxes are reorganized so that the boxes of a brand are adjacent to each other. The objective of this new approach is to minimize the movement of the boxes during the reorganization process while keeping the boxes of a brand adjacent to each other. The approach, however, does not ensure the optimality of the solution in terms of the original problem, that is, the problem to minimize the movement of existing boxes while keeping boxes of the same brands adjacent to each other. Even though this heuristic method may produce a suboptimal solution, we could obtain a satisfactory solution within a satisfactory time, which are acceptable by real world experts. In order to justify the quality of the solution by the heuristic approach, we generate 100 problems randomly, in which the number of cells spans from 2,000 to 4,000, solve the problems by both of our heuristic approach and the original integer programming approach using a commercial optimization software package, and then compare the heuristic solutions with their corresponding optimal solutions in terms of solution time and the number of movement of boxes. We also implement our heuristic approach into a storage location assignment system for the Internet shopping mall.

• Journal of Chest Surgery
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• v.38 no.6 s.251
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• pp.403-409
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• 2005

Pulmonary atresia with intact ventricular septum is morphologically heterogeneous, and the surgical outcome remains suboptimal compared to other complex congenital heart defects. We evaluated the long-term results for repair of pulmonary atresia with intact ventricular septum, Material and Method: Between January 1992 and June 2004, 38 patients underwent repair of pulmonary atresia with intact ventricular septum. The average age was 18 days $(2\~382\;days)$. The average Z-value of the tricuspid annulus diameter was -3.1$(-5.6\~0.8)$. Thirteen $(36\%)$ patients had right ventricle-to-coronary artery fistulas, and $4(11\%)$ patients had right ventricle-dependent coronary circulation. Average follow-up was 55 months $(3\;months\~2.2\;years)$, Result: Twenty-four patients under-went initial right ventricle (RV) decompression and 14 patients underwent systemic-to-pulmonary arterial shunt only. The average size of the tricuspid annulus of the patients who underwent RV decompression was significantly larger than that of the patients who underwent systemic-to-pulmonary arierial shunt only (Z-value -2.2 vs. -4.8, p=0.000). There were $5(13\%)$ early and 1 late deaths. Early deaths occurred in 3 patients who had undergone RV decompression, and in 2 patients who had undergone systemic-to-pulmonary arterial shunt only (p=1.0). Biventricular repair was achieved in $12(32\%)$ patients, single ventricular repair in $8(21\%)$, and one and a half ventricular repair in $4(l1\%)$ patients. Nine $(24\%)$ patients are waiting for the definitive repair. Kaplan-Meier survival at 5 and 8 years was $83.2\%$, respectively. Conclusion: Most of the deaths occurred after the initial palliation. Overall long-term survival was satisfactory. Early mortality should be reduced with careful preoperative evaluation and proper surgical strategy.