• Journal of Gastric Cancer
• /
• v.8 no.4
• /
• pp.176-181
• /
• 2008

Purpose: The adipocyte-derived cytokine leptin plays a major role in the control of stable body weight by suppressing food intake and increasing energy metabolism. Leptin regulates the cell proliferation of various epithelial cells and it may be involved in the promotion of cancer. Leptin and its receptor are highly expressed in gastric adenocarcinoma, but the association between the serum leptin level and the tissue expression of leptin is uncertain. We evaluated the serum leptin level and the expressions of leptin and leptin receptor in gastric cancer, and we explore the possible mechanism and role of leptin in the carcinogenesis of gastric cancer. Materials and Methods: 72 carcinomas that were curatively resected at our hospital from October 2005 to March 2007 were included in this study. By immunoassay and immunohistochemical staining, we evaluated the serum leptin level and the expressions of leptin and its receptor, and we analyzed their relationship together with the clinicopathological variables. Results: The serum leptin level was increased as the patient's BMI increased and it was decreased in H. pylori infected patients. The expression of leptin was increased as the TNM stage increased (P=0.014), and the expression of leptin receptor in the intestinal type gastric adenocarcinoma was higher than that in the diffuse type gastric adenocarcinoma (71.4% vs 28.6%, respectively, P=0.033). Conclusion: There was no significant correlation between the serum leptin level and expression of leptin in gastric cancer patients. The expression of leptin was associated with the TNM stage, but its role in the pathogenesis of gastric cancer has to be elucidated.

• Tuberculosis and Respiratory Diseases
• /
• v.61 no.1
• /
• pp.46-53
• /
• 2006

Background: Intra-abdominal hypertension (IAH) is defined as the presence of either an intra-abdominal pressure (IAP) ${\geq}12mmHg$ or an abdominal perfusion pressure (APP = mean arterial pressure - IAP) ${\leq}60mmHg$. Abdominal compartment syndrome (ACS) is defined as the presence of an IAP ${\geq}20mmHg$ together with organ failure. The purpose of this study was to investigate the prevalence of IAH and ACS on the day of admission and the effects of these maladies on the prognosis of critically ill patients in the ICU. Methods: At the day of admission to the ICU, the IAP was recorded by measuring the intravesicular pressure via a Foley catheter. The APACHE II and III scores were checked and SAPS II was also scored during the days the patients were in the ICU. The primary end point was the prevalence of IAH and ACS at the day of admission and the correlation between them with the 28-days mortality rate. The measurement of IAP continued until the 7th day or the day when the patient was transferred to the general ward before 7th day, unless the patient died or a Foley catheter was removed before 7th day. Patients were observed until death or the 28th day. Results: A total of 111 patients were enrolled. At the day of admission, the prevalence of IAH and ACS were 47.7% and 15.3%, respectively and the mean IAP was $15.1{\pm}8.5mmHg$. The rates of IAH for the survivor and the non-survivor groups were 56.5% and 71.4%, respectively, and these were not significantly different (p=0.593). Yet the rates of ACS between these two groups were significantly different (4/62, 6.5% vs. 13/49, 26.5%; Odds Ratio = 5.24, 95% CI = 1.58-17.30, p=0.004). Conclusion: In the present study, the prevalence of IAH was 47.7% and the prevalence of ACS was 15.3% on the day of admission. ACS was associated with a poor outcome for the critically ill patients in the ICU.

• Restorative Dentistry and Endodontics
• /
• v.33 no.5
• /
• pp.463-471
• /
• 2008

This study investigated the clinical effectiveness and safety of sealed bleaching compared to conventional in-office bleaching using a randomized clinical trial of split arch design. Ten participants received a chairside bleaching treatment on the upper anterior teeth, and each side was randomly designated as sealed or control side. A mixture of Brite powder (PacDent, Walnut, USA), 3% hydrogen peroxide and carbamide peroxide (KoolWhite, PacDent, Walnut, USA) were used as bleaching agent. The control side was unwrapped and the experimental side was covered with a linear low density polyethylene (LLDPE) wrap for sealed bleaching. The bleaching gel was light activated for 1 hour. The tooth shades were evaluated before treatment, after treatment, and at one week check up by means of a visual shade (VS) assessment using a value oriented shade guide and a computer assisted shade assessment using a spectrophotometer (SP). The data were analyzed by paired t-test. In the control and sealed groups, the visual shade scores after bleaching treatment and at check up showed statistically significant difference from the preoperative shade scores (p<.05). The shade scores of the sealed group were significantly lighter than the control immediately after bleaching and at the check-up appointment (p<0.05). Compared to prebleaching status, the ${\Delta}E$ values at post bleaching condition were $4.35{\pm}1.38\;and\;5.08{\pm}1.34$ for the control and sealed groups, respectively. The ${\Delta}E$ values at check up were $3.73{\pm}1.95\;and\;4.38{\pm}2.08$ for the control and sealed groups. ${\Delta}E$ values were greater for the sealed group both after bleaching (p<.05) and at check up (p<.05). In conclusion, both ${\Delta}E$ and shade score changes were greater for the sealed bleaching group than the conventional bleaching group, effectively demonstrating the improvement of effectiveness through sealing.

• Journal of the Korean Society of Food Science and Nutrition
• /
• v.37 no.4
• /
• pp.459-464
• /
• 2008

This study was performed to investigate the effect of calcium-rich large anchovy on calcium metabolism in rats for 5 weeks. Experimental animals were randomly assigned to 5 treatments with 14 heads of Spraque Dawley male rats in each group. The experimental diets were as follows; market milk group (M) as control, market milk+calcium-rich large anchovy group (MA), market milk＋calcium carbonate group (MC), market milk+calcium lactate group (ML), and enriched-calcium market milk group (M2), which were formulated with commercially semi-purified rat chow (AIN-diet) to maintain the same level of calcium (1%) in all groups. Femur lengths of M and M2 groups were significantly higher than other groups. Bone mineral density (BMD) and bone mineral content (BMC) and calcium content of femur were the highest in MA group than other groups. In vitro and in vivo calcium absorption rates were high in MA group (7.30% vs 27.50%) compared with those of the other groups. Serum total-cholesterol and HDL-cholesterol levels were significantly different between M group and MA group (p<0.05). Creatinine levels were significantly higher in M, MA and MC groups than in M2 group (p<0.05). Serum calcium, osteocalcin and ALPase activities were higher in calcium-rich large anchovy (MA) group among the treatments, but there was no significant difference. SGOT activity was significantly lower in M2 group than those of M, MA and MC groups (p<0.05). These results may indicate that the calcium-rich large anchovy has enforced the BMD, BMC and calcium absorption rates of in vitro and in vivo compared with the other groups and might be a calcium-enriched food with large anchovy.

• Korean Journal of Poultry Science
• /
• v.42 no.3
• /
• pp.257-265
• /
• 2015

Heat conditioning at an early age has been known to help chickens cope with heat stress later in life. The present study was conducted to determine the effects of heat conditioning at 5 days of age in broilers repeatedly exposed to high ambient temperature later in life. A total of 256 day-old Arbor Acre boiler chicks were housed in two identical rooms with a 23-h light/1-h dark cycle and provided with feed and water ad libitum. At 5 days of age, the birds in one room were exposed to $37^{\circ}C$ for 24 hours, while those in the other room served as controls. On day 21, half of the birds in each room were moved into the other room so that each room contained both control and heat-conditioned birds. After a 7-day adaptation period, the birds in one room were exposed to high ambient temperature ($21^{\circ}C{\rightarrow}31^{\circ}C$) for 3 days, whereas those in the other room were kept at normal temperature. The same 3-day exposure to high ambient temperature was repeated two weeks later. Hence, there were four treatment groups (CON+CON: control+control; CON+HS: control+high ambient temperature; HC+CON: heat conditioning+control; and HC+HS: heat conditioning+high ambient temperature). Repeated heat stress resulted in decreased feed intake, water intake, body weight gain, and spleen weight (p<0.05) and increased rectal temperature (p<0.05), mortality, and plasma corticosterone concentrations. The relative weight of the spleen was increased in the heat-conditioned group (p<0.05). Plasma biochemicals were also influenced by high temperature. Thus, no beneficial effects of heat conditioning at an early age were detected in broilers repeatedly exposed to high ambient temperature later in life.

• Journal of Chest Surgery
• /
• v.31 no.9
• /
• pp.873-876
• /
• 1998

Background: High-dose aprotinin has been reported to enhance the anticoagulant effects of heparin during cardiopulmonary bypass ; hence, som authors have advocated reducing the dose of heparin in patients treated with aprotinin. Material and Method: The ACT was measured before, during and after cardiopulmonary bypass, with Hemochron 801 system using two activators of celite(C-ACT) and kaolin(K- ACT) as surface activator. From June, 1996 to February, 1997, 22 adult patients who were scheduled for elective operation were enrolled in this study. Result: The ACT without heparin did not differ between C-ACT and K-ACT. At 30 minutes after anticoagulation with heparin and cardiopulmonary bypass, the average C-ACT was 928${\pm}$400 s; K-ACT was 572${\pm}$159s(p<0.05). After administration of protamine, C-ACT was 137${\pm}$26 s; K-ACT was 139${\pm}$28s, which were not statistically significant. Conclusion: Our results showed that the significant increase in the ACT during heparin- induced anticoagulation in the presence of aprotinin was due to the use of celite as surface activator, rather than due to enhanced anticoagulation of heparin by aprotinin. We conclude that the ACT measured with kaolin provides better monitoring of cardiac surgical patients treated with high dose aprotinin than does the ACT measured with celite. The patients treated with aprotinin should receive the usual doses of heparin.

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

• Journal of Chest Surgery
• /
• v.38 no.6 s.251
• /
• pp.410-414
• /
• 2005

There are several options for choosing a graft in CABG, we routinely chose LIMA for LAD and great saphenous vein for other target vessels. To evaluate the posoperative graft patency, we have studied the results using a 16 slices multi-detector computed tomography. Material and Method: From 1995 to 2003, 80 CABG patients who did not complain any event of MACE have been examined by 16-MDCT, mostly in an out patient clinic. Result: There were 61 men and 19 women. MDCT was used as early as 7 days to 9 years post-operatively with a median follow-up period of 6.5 years, and mean follow-up peiod of $31.5\pm25.4$ months. Mean age was $58.4\pm12.6$ years old in men and $61.5\pm17.2$ years old in women. 72180 patients received LIMA to LAD, and all other patients received vein grafts for bypass. The target vessel of vein grafts were 8 in LAD, 47 in RCA, 60 in diagonals, and 61 in obtuse marginals. Among them 42 sequential anastomoses were performed. The mean graft number was $3.1\pm1.8$ grafts. 5 year graft patency rate of each grafts was as followings; $93.1\%$ in LIMA to LAD, $94.9\%$ in vein to diagonals, $92.1\%$ in vein to obtuse marginals, and $79.2\%$ in vein to RCA. Sequential grafting showed better graft patency than the isolated grafting $(95.2\%\;vs\;78.7\~95.0\%)$. Conclusion: In this study, CABG with LIMA and saphenous veins showed satisfactory longterm results. 16-MDCT provided good images for follow-up study after CABG. Additionally, as radiologic tools (64-MDCT, MRI) improve more in the future, they can be used for diagnosing preoperative anatomical coronary disease as well as cardiac functions.

• Journal of Chest Surgery
• /
• v.34 no.6
• /
• pp.485-489
• /
• 2001

Background: The most important factor in preventing sternal complications is stable sternal approximation. We have tried to find the most effective sternal closure method by examining the incidence of sternal dehiscence with or without infection in patients with cardiac surgery through median sternotomy. Material and Method: This study was performed in 489 patients over 45 years of age with median sternotomy for open cardiac surgery. Simple closure with interrupted 6 wires was performed in 159 patients, figure-of-8 closure technique in 119, overlapping interrupted closure using 10 wires in 150, and combined closure technique of interrupted simple closure and figure-of-8 suture closure in 61. Two hundred thirty-four patients underwent valve and aortic operations and 213 patients coronary artery bypass surgery. Result: Sternal dehiscence with or without infection occurred in 12 (2.5 %) patients. The complication developed in 5 of 159 patients (3.1%) with six interrupted simple closure, in 4 of 119 patients (3.4%) with figure-of-8 closure, and in 3 of 150 patients (2.0%) with overlapping interrupted closure using 10 wires, but there was no complication in 61 patients with combined closure technique (relative risk for other closure techniques, p<0.05). There was no significant difference in the incidence of the sternal complication between valve and aortic operation group and coronary artery bypass group (3.0% vs 2.3%, not significant), but diabetes mellitus was a significant independent risk factor (odds ratio and multivariate analysis, p<0.05). Conclusion: The sternal closure technique that combines simple interrupted suture closure and figure-of-8 suture closure may be a more useful technique to enhance sternal stabilization compared to other closure techniques, such as simple interrupted closure, 8-figure closure, and overlapping interrupted closure.

• Journal of Chest Surgery
• /
• v.32 no.9
• /
• pp.806-812
• /
• 1999

Background: Selection of reconstruction route in esophageal cancer surgery is based on the patient's status, characteristics of tumor, surgeon's preference and experience. Of the various routes, it has been documented that subcutaneous or substernal route may prolong operation time and may be vulnerable to postoperative respiratory complications. This study was designed to evaluate whether the selection of reconstruction route affects the surgical outcomes. Material and Method: Of 131 patients who have undergone resection and reconstruction for esophageal cancer, posterior mediastinal route(Group I, n=34), substernal route (Group II, n=31), and subcutaneous route(Group III, n=21) were retrospectively reviewed in 86 patients. Results of early operations and morbidities were compared between the groups. Result: There was a male prevalence(79 of males vs. 7 of females). There were 81 squamous cell cancers and 5 adenocarcinomas. There were no differences between groups in weight, height, age, cancer staging and location, and in the preoperative anesthetic risk evaluation and pulmonary function test(p=NS). Postoperative mechanical ventilation time was longer in Group I(20.6 hours) than in Group II(7.8 hours) or III(3.4 hours)(p=0.005). Duration of stay in the intensive care unit was prolonged in Group III(6.4 days) compared to Group I (3.9 days) or II(3.1 days)(p=0.043). No differences were noted in the duration of hospital stay between the groups(p=NS). Blood transfusion was needed in 30 out of 34 patients in Group I compared to 14/31 in Group II or 15/21 in Group III(p=0.001). The mean amount of transfusion for each patient was also higher in Group I(3,833 mL) than in Group II(1535 mL) or Group III(1419 mL)(p=0.04), but there was no difference in the inreoperation due to bleeding. Ea ly mortality rate was substantially higher in Group I(17.6%) but the differences between the groups were insignificant(p=NS). Although sepsis was a more prevalent cause of death in Group I, it was not related to anastomotic leak. Other morbidities did not differ between the groups(p=NS). Conclusion: In above results show that the reconstruction route does not affect the outcome of esophageal cancer surgery. We believe that the selection of reconstruction route can be based on the surgeon's preference and experience.