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
/
v.4
no.4
/
pp.230-234
/
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)
Kim, Dae Hoon;Yun, Hyo Yung;Song, Young Jin;Ryu, Dong Hee;Min, In Choel;Sung, Rohyun;Lee, Sang Eok
Journal of Gastric Cancer
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v.8
no.2
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pp.70-78
/
2008
Purpose: VEGF-C and VEGF-D are angiogenetic factors, and abnormal expression of E-cadherin hasa role in the progression of gastric carcinoma. The aim of this study was to evaluate the relationship between the expression of E-cadherin, VEGF-C and VEGF-D with the presence of lymph node metastases (LNM) using cytokeratin 18 in early gastric cancer (EGC). Materials and Methods: Immunohistochemical staining for E-cadherin, VEGF-C and VEGF-D was performed in 49 EGC patients from March 1997 to December 2002. To evaluate the real extent of LNM, 1,562 lymph nodes from 49 patients were re-examined with the use of cytokeratin 18. Results: Eleven (0.7%) LNM were newly found in 12.2% (n=6) of patients. The real LNM rate was 3.6% in mucosal invasive (m) cancer and 38.1% in submucosal invasive (sm). Stage migration was seen in three patients (6.1%). Abnormal expression of E-cadherin was detected in 36.7% of the patients and expression of VEGF-C and VEGF-D was detected in 16.3% and 36.7% of the patients, respectively. Abnormal expression of E-cadherin was significantly correlated with tumor differentiation (P=0.0103) and Lauren classification (P<0.0001). There was no positive relationship of VEGF-C and VEGF-D expression with the clinicopathological findings for EGC including LNM. However, the frequency of lymph node metastases was significantly higher in patients that demonstrated abnormal expression of E-cadherin with positive immunoreactivity of VEGF-C or VEGF-D (P=0.031). Conclusion: In present study, we could not demonstrate a relationship between the presence of LNM and expression of VEGF-C and VEGF-D in EGC. However, VEGF-C or VEGF-D expression, in addition to the abnormal expression of E-cadherin, was correlated with the real extent of LNM in EGC.
The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the third year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows : - analysing and differentiating of epidemic febrile disease - analysing and differentiating in accordance with the Sasang constitutional medicine baced on four-type recognition - differentiation of diease according to pathological changes of Chong and Ren channels - standards for diagnosis of women's disease - standards for diagnosis of children's disease - standards for diagnosis of motor and sensor disturbance(-muscle born joint etc.) - standards for diagnosis of neuropsychiatric diease - standards for diagnosis of five sense organ diease - standards for diagnosis of external disease. The indivisual diagnosis pattern was arranged by the diagnostic requirments in the following odor : another name, notion of diagnosis pattern, index of differentiation of symptoms and signs, the main point of diagnosis, analysis of diagnosis pattern, discrimination of diagnosis pattrrn, prognosis, a way of curing a diseases, prescription, herbs in common use, dieases appearing the diagnosis pattern, documents. The standards for diagnosis of each disease was arranged by the diagnostic requirments in the following odor. another name, notion of diease, the main point of diagnosis, analysing and differentiating of disease, analysis of diease, discrimination of disease, prognosis, a way of curing and prescription of disease, dieases In western medicine appearing the disease in oriental medicine, documents.
Purpose: The purpose of this study was to compare the cleansing performance of a distilled water, a diluted solution of sodium hypochlorite as a household bleaching cleanser and three alkaline peroxide cleansers in vivo plaque deposits by using scanning electron microscope. Materials and methods: Five individuals were selected from department of the prosthodontics in Pusan National University Hospital, and each of them was inserted with specimens for plaque accumulation in their temporary dentures for 48 hours. The specimens were removed and cleaned by each cleansing agents for 8 hours. Scanning electron micrographs were made from the specimens at a magnification of ${\times}2,000$. A panel of ten persons with a dental or paradental background, but not directly involved in the study, was selected to analyze the photomicrographs to determine which denture cleanser was more effective in removing plaque. Results: Diluted solution of sodium hypochlorite was the most effective at removing plaque following $Polident^{(R)}$, $Cleadent^{(R)}e$, $Bonyplus^{(R)}$ and distilled water in order. But there was no significant difference of cleansing efficacy between diluted solution of sodium hypochlorite and $Polident^{(R)}$, $Polident^{(R)}$ and $Cleadent^{(R)}e$, $Cleadent^{(R)}e$ and $Bonyplus^{(R)}$, respectively (P > .05). Alkaline peroxide cleansers by themselves cannot adequately remove accumulated plaque deposits, especially if the deposits are heavy. Corrosion could be seen on the surface of non-precious alloy specimens immersed in diluted solution of sodium hypochlorite. Conclusion: It is recommended to use of alkaline peroxide type cleansers with brushing whenever possible, since denture cleanliness is often poor due to the relative inefficiency of these cleansers.
Purpose: This study is designed to investigate the various impacts of different types of scaler tips such as cooper alloy base tip and the others on the surface roughness of teeth and implant by the method which is currently in clinical use. Materials and methods: Four different types of disc shaped porcelain, titanium, zirconia, and Type III gold alloy dental materials sized 15 mm diameter, 1.5 mm thickness were used for the experiment. Plastic hand curette (Group PS), cooper alloy new tip (Group IS), and stainless steel tip (Group SS) were used as testing appliances. A total of 64 specimens were used for this study; Four specimens for each material and appliance group. Surface roughness was formed with 15 degree angle in ultrasonic scaler tip and with 45 degree angle in hand curette of instrument tip and the specimen surface with 5 mm long, one horizontal-reciprocating motion per second for 30 seconds by 40 g force. To survey the surface roughness of each specimen, a field emission scanning electron microscope, an atomic force microscope, and a surface profiler were used. (Ra, ${\mu}m$). Results: According to SEM, most increased surface roughness was observed in SS group while IS groups had minimal roughness change. Measurement by atomic force microscope presented that the surface roughness of SS group was significantly greater than those of PS, IS and control groups in the type III gold alloy group (P<.05). IS group showed lesser surface roughness changes compared to SS group in porcelain and gold alloy group (P<.05). According to surface profiler, surface roughness of SS group showed greater than those of PS, IS and control groups and IS group showed lesser than those of SS group in all specimen groups. Type III gold alloy group had large changes on surface roughness than those of porcelain, titanium, zirconia (P<.05). Conclusion: The result of this study showed that newly developed copper alloy scaler tip can cause minimal roughness impacts on the surface of implant and dental materials; therefore this may be a useful alternative for prophylaxis of implant and restored teeth.
Purpose: Endoscopic incision and submucosal dissection (EISD) is a technique that is being implemented for the resection of gastric adenomas and early gastric cancer (EGC). Since EISD requires a high degree of skill and experience, and due to its association with a moderate risk of gastrointestinal bleeding, its use has been limited. The objective of this study is to investigate the clinical benefits of EISD based upon clinical data on the EISD procedure. Materials and Methods: This study was conducted at Soonchunhyang University Hospital and it included 179 gastric adenoma and early gastric carcinoma lesions from 164 patients who had undergone an EISD from February 2003 to May 2005. Results: Among the total of 179 lesions, the distributions of EGC and adenomas were 70.3% (126/179) and 23.4% (42/179) respectively. The sizes of lesions were divided into 10 mm or less, $11{\sim}20\;mm,\;21{\sim}30\;mm$ and greater than 31 mm and each rates are 10.0% (18/179), 46.3% (83/179), 30% (50/179) and 15.0% (28/179). Among 120 cases which could be measured depth of lesion in according to pathologic findings, m1 (0.8%, 1/120), m2 (38.3%, 46/120), m3 (25%, 57/120), sm1 (11.7%, 14/120), sm2 (1.6%, 2/120) were diagnosed as early stages of gastric cancer. The complete resection rate was 85.2% (150/176) and en-bloc resection rate was 96.0% (169/176). Complications as such as perforation and bleeding developed in 4.4%(8/179) and 21.2% (38/179), respectively. Conclusion: EISD is an effective in the endoscopic treatment for gastric adenoma and early gastric cancers. However, further evaluation of this method and long-term follow-up will be necessary for an evaluation of the recurrence rate after resection of a tumor.
Purpose: Surgical wound complications remain a cause of morbidity and mortality among postoperative patients, and the cost of caring for patients with a surgical wound complication is substantial. The purpose of this study was to evaluate the ability of a vinyl wound protector to reduce the rate of wound complications when used in clean-contaminated surgery. Materials and Methods: Between May 2006 and September 2006, 295 patients with a gastric cancer that underwent gastric surgery were studied prospectively, and the patients were randomized into one of two groups: the no wound protector group (n=137) or the polyethylene protector group (n=132). Results: The demographics and operation type and operation time were similar for patients in both groups. The rate of wound complication was different between patients in the no protector group (n=42) and the polyethylene protector group (n=12) (P=0.001) and the rates of seroma (P=0.001), infection (P=0.030) and dehiscence (P=0.282) were different for the two groups. The postoperative hospital stay was significantly shorter in the polyethylene protector group of patients (P=0.040). Conclusion: The use of a polyethylene protector resulted in a reduction of the surgical wound complication rate, and the cost of caring for patients, and morbidity and mortality among postoperative patients could be reduced.
Lee, Jae Hee;Cha, Seung Ik;Jang, Sang Su;Jung, Chi Young;Park, Jae Yong;Park, Jun Sik;Jung, Tae Hoon;Kim, Chang Ho
Tuberculosis and Respiratory Diseases
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v.54
no.3
/
pp.274-282
/
2003
Background : Tuberculous lymphadenitis is one of the most common forms of extrapulmonary tuberculosis. It was recently reported that the treatment for tuberculous lymphadenitis could be shortened to 6 months without increasing the risk of a relapse. However, there is no report of a prospective randomized study on the use of 6-month chemotherapy with HERZ for cervical lymphadenitis, which is regimen recommended in the areas concerned with the initial drug resistance. The aim of this study is to evaluate the efficacy of the 6-month regimen with HERZ for cervical lymphadenitis in areas where there is a high prevalence of drug resistance in Korea. Method : From January 1997 to February 2002, 92 patients with cervical tuberculous lymphadenitis were recruited from Kyungpook national university hospital. Forty-six patients were given the 6-month regimen(2HERZ/4HER) and the other forty-six patients were given the 9-month regimen(2HERZ/7HER). Result : Of the 46 patients given the 6-month regimen, 5 had residual lymph nodes greater than 5 mm after the completion of treatment and 3 had new lymph nodes or an increased lymph node size during the follow-up period. Of the 46 patients in the 9-month regimen, 9 had residual lymph nodes and 8 had new events during the follow-up period. There were no significant differences between the two groups. Conclusion : These results suggest that the 6-month HERZ regimen can be used safely as the initial treatment for tuberculous lymphadenitis in areas with a similar prevalence of drug resistance.
Choi, Hye Sook;Choi, Cheon Woong;Park, Myung Jae;Kang, Hong Mo;Yoo, Hong Ji
Tuberculosis and Respiratory Diseases
/
v.62
no.4
/
pp.276-283
/
2007
Background: A national health care initiative recommends routine spirometry screening of all smokers over age 45 or patients with respiratory symptoms. In response to the recommendation, new, simple, and inexpensive desktop spirometers for the purpose of promoting widespread spirometric screening were marketed. The performance of these spirometers was evaluated in vivo testing with healthy subjects. However, the clinical setting allows spirometric assessment of various pathologic combinations of flow and volume. Objective: The aim of this study was to compare the accuracy of a desktop spirometer to a standard laboratory spirometer, in a clinical setting with pathologic pulmonary function. Method: In a health check-up center, where screening pulmonary funct test was performed using the HI-801 spirometer. Subjects who revealed the ventilation defect in screening spirometry, performed the spirometry again using the standard Vmax spectra 22d spirometer in a tertiary care hospital pulmonary function laboratory. Pulmonary function test with both spirometer was performed according to the guidelines of the American Thoracic Society. Results: 109 patients were enrolled. Pulmonary function measurements (FVC, $FEV_1$, PEFR, FEF25%-75%) from the HI-801 correlated closely (r=0.94, 0.93, 0.81, 0.84, respectively) with those performed with the Vmax spectra 22d and showed the good limits of agreement and differences between the 2 devices; FVC +0.35 L, $FEV_1$ +0.16 L, PEFR +1.85 L/s, FEF25%-75%-0.13 L/s. With the exception of $FEV_1$, FEF25%-75%, these differences were significant(p<0.05) but small. Conclusion: The HI-801 spirometer is comparable to the standard laboratory spirometer, Vmax spectra 22d, with high accurary for $FEV_1$ and FVC and acceptable differences for clinical use.
Kang, Hyun Soo;Sung, June Seung;Kim, Sun Hui;Back, Hee Jo;Kim, Young Ok;Kim, Chan Jong;Choi, Young Youn;Hwang, Tai Ju
Clinical and Experimental Pediatrics
/
v.49
no.8
/
pp.870-874
/
2006
Purpose : Popular use of fetal ultrasonography has increased to detect congenital hydronephrosis(CH) which is the most common anomaly prenatally detected. We'd like to determine the frequency and clinical characteristics of prenatally diagnosed CH and outcome of ureteropelvic junction stenosis(UPJS). Methods : The records of births between January 1994 and June 2003 in Chonnam National University Hospital(CNUH), and the records of children who were diagnosed with CH in the Department of Pediatrics of CNUH during the above period, were retrospectively analyzed. In the patients with UPJS, the initial anterior posterior diameters of renal pelvis(APD) were compared between the spontaneous regression (SR) and operation group(OP). In the SR group, sequential regression rates of APD were estimated. Results : Among a total 9,076 births, 231(2.54 percent) patients with 293 renal units were diagnosed as CH and 19(6.78 percent) renal units spontaneously regressed 3 days after birth. In 228 children(56 bilateral; 172 unilateral; total 284 renal units) diagnosed with CH in the department of pediatrics of CNUH, male(71.9 percent) and left kidney(69.2 percent) predilection were found and 78.1 percent of CH were caused by UPJS. The initial APD of the SR group(121 units) in UPJS was $7.8{\pm}6.28mm$, which was significantly smaller than the APD($26.8{\pm}12.14mm$) of the OP group(25 unit)(P<0.05). In the SR group, 81 percent spontaneously regressed within one year. Conclusions : In CH, male and left kidney predilection were found. UPJS was the most common cause of CH and initial APD in UPJS at 3 days of age was a good prognostic indicator. Close monitoring should be done for at least one year because most SR in UPJS regressed spontaneously within one year.
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