• Journal of Gastric Cancer
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• v.13 no.1
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• pp.51-57
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• 2013

Purpose: Additional gastrectomy is needed after endoscopic resection for early gastric cancer when pathology confirms any possibility of lymph node metastasis or margin involvement. No studies depicted the optimal type of surgery to apply in these patients. We compared the short-term and long-term outcomes of laparoscopic gastrectomy with those of open gastrectomy after endoscopic resection to identify the optimal type of surgery. Materials and Methods: From 2003 to 2010, 110 consecutive patients who underwent gastrectomy with lymphadenectomy either by laparoscopic (n=74) or by open (n=36) for gastric cancer after endoscopic resection were retrospectively analyzed. Postoperative and oncological outcomes were compared according to types of surgical approach. Results: Clinicopathological characteristics were comparable between the two groups. Laparoscopic group showed significantly shorter time to gas passing and soft diet and hospital day than open group while operation time and rate of postoperative complications were comparable between the two groups. All specimens had negative margins regardless of types of approach. Mean number of retrieved lymph nodes did not differ significantly between the two groups. During the median follow-up of 47 months, there were no statistical differences in recurrence rate (1.4% for laparoscopic and 5.6% for open, P=0.25) and in overall (P=0.22) and disease-free survival (P=0.19) between the two groups. Type of approach was not an independent risk factor for recurrence and survival. Conclusions: Laparoscopic gastrectomy after endoscopic resection showed comparable oncologic outcomes to open approach while maintaining benefits of minimally invasive surgery. Thus, laparoscopic gastrectomy can be a treatment of choice for patients previously treated by endoscopic resection.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.8
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• pp.4871-4875
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• 2013

This meta-analysis was performed to evaluate and compare the outcomes of robotic gastrectomy (RG) and laparoscopic gastrectomy (LG) for treating gastric cancer. A systematic literature search was carried out using the PubMed database, Web of Knowledge, and the Cochrane Library database to obtain comparative studies assessing the safety and efficiency between RG and LG in May, 2013. Data of interest were analyzed by using of Review Manager version 5.2 software (Cochrane Collaboration). A fixed effects model or random effects model was applied according to heterogeneity. Seven papers reporting results that compared robotic gastrectomy with laparoscopic gastrectomy for gastric cancer were selected for this meta-analysis. Our metaanalysis included 2,235 patients with gastric cancer, of which 1,473 had undergone laparoscopic gastrectomy, and 762 had received robotic gastrectomy. Compared with laparoscopic gastrectomy, robotic gastrectomy was associated with longer operative time but less blood loss. There were no significant difference in terms of hospital stay, total postoperative complication rate, proximal margin, distal margin, numbers of harvested lymph nodes and mortality rate between robotic gastrectomy and laparoscopic gastrectomy. Our meta-analysis showed that robotic gastrectomy is a safe technique for treating gastric cancer that compares favorably with laparoscopic gastrectomy in short term outcomes. However, the long term outcomes between the two techniques need to be further examined.

• Archives of Plastic Surgery
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• v.44 no.1
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• pp.53-58
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• 2017

Background Adequate fixation of replanted digits is essential not only for short-term healing but for long-term function. Various bony fixation methods using Kirschner (K-) and intraosseous wire are available in replantation. We examined clinical and radiographic outcomes of fixation methods on bone union after digital replantation. Methods A single institutional retrospective review identified 992 patients who had undergone 1,247 successful replantations between July 2009 and September 2015. Exclusion criteria included amputations of the distal phalanx, comminuted fractures, and intra-articular fractures. Patients were classified according to 5 categories of fixation methods: single K-wire, double longitudinal K-wires, cross K-wires, wire with, and wire without K-wire support. Bone union was evaluated by 5-month postoperative X-ray and fixation outcomes were compared across the 5 groups. Results The exclusion criteria were applied, and 88 patients with 103 replanted digits remained for analysis. Single K-wire fixation was used in 40 digits, double longitudinal K-wires in 30, and cross fixation in 14. Wire with and without K-wire support was required in 15 and 4 digits. Nonunion was observed in 32 digits (31.1%), of which 13 required additional operations such as bone graft or corrective osteotomy. The highest percent of nonunion was observed after cross fixation (35.7%) and the lowest after wire alone (25.0%). Conclusions In this study, contrary to general knowledge, we found that single K-wire fixation was not associated with poorer outcomes. Successful bone union outcomes may be achieved by careful selection of bone fixation methods. This study provides useful information for planning bone fixation in digital replantation.

• Journal of Gastric Cancer
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• v.19 no.1
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• pp.83-91
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• 2019

Purpose: This study aimed to compare the oncologic and short-term outcomes of laparoscopic distal gastrectomy (LDG) and open distal gastrectomy (ODG) for advanced gastric cancer (AGC). Materials and Methods: From July 2006 to November 2016, 384 patients underwent distal gastrectomy for AGC. Data on short- and long-term outcomes were prospectively collected and reviewed. Propensity score matching was applied at a ratio of 1:1 to compare the LDG and ODG groups. Results: The operative times were longer for the LDG group than for the ODG group. However, the time to resumption of diet and the length of hospital stay were shorter in the LDG group than in the ODG group (4.7 vs. 5.6 days, P=0.049 and 9.6 vs. 11.5 days, P=0.035, respectively). The extent of lymph node dissection in the LDG group was more limited than in the ODG group (P=0.002), although there was no difference in the number of retrieved lymph nodes between the 2 groups. The 3-year overall survival rates were 98% and 86.9% (P=0.018), and the 3-year recurrence-free survival rates were 86.3% and 75.3% (P=0.259), respectively, in the LDG and ODG groups. Conclusions: LDG is safe and feasible for AGC, with earlier recovery after surgery and longterm oncologic outcomes comparable to those of ODG.

• Journal of Gastric Cancer
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• v.20 no.4
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• pp.431-441
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• 2020

Purpose: Various studies have indicated that reduced-port robotic gastrectomies are safe and feasible for treating patients with early gastric cancer. However, there have not been any comparative studies conducted that have evaluated patients with clinically advanced gastric cancer. Therefore, we aimed to compare the perioperative outcomes of D2 lymph node dissections during reduced-port robotic distal subtotal gastrectomies (RRDGs) and conventional 5-port laparoscopic distal subtotal gastrectomies (CLDGs). Materials and Methods: We retrospectively evaluated 118 patients with clinically advanced gastric cancer who underwent minimally invasive distal subtotal gastrectomies with D2 lymph node dissections between February 2016 and November 2019. To evaluate the patient data, we performed a 1:1 propensity score matching (PSM) according to age, sex, body mass index, American Society of Anesthesiologists physical status classification score, and clinical T status. The short-term surgical outcomes were also compared between the two groups. Results: The PSM identified 40 pairs of patients who underwent RRDG or CLDG. The RRDG group experienced a significantly longer operation time than the CLDG group (P<0.001), although the RRDG group had significantly less estimated blood loss (P=0.034). The number of retrieved extraperigastric lymph nodes in the RRDG group was significantly higher than that of the CLDG group (P=0.008). The rate of postoperative complications was not significantly different between the two groups (P=0.115). Conclusions: D2 lymph node dissections can be safely performed during RRDGs and the perioperative outcomes appear to be comparable to those of conventional laparoscopic surgeries. Further studies are needed to compare long-term survival outcomes.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.17 no.2
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• pp.170-176
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• 2004

Refractive surgeries for myopia are rapidly spreading in our daily lives. In this study Korean and foreign follow-up studies, mainly focused on long-term outcomes of LASIK and LASEK, were analyzed. Examining the evidence of the efficacy, accuracy, stability, complications and patient satisfaction will help refine our approach to refractive surgeries.

• Journal of Korean Society for Atmospheric Environment
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• v.32 no.1
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• pp.114-126
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• 2016

Many cohort studies have reported associations of individual-level long-term exposures to $PM_{10}$ and health outcomes. Individual exposures were often estimated by using exposure prediction models relying on $PM_{10}$ data measured at national regulatory monitoring sites. This study explored spatial and temporal characteristics of regulatory $PM_{10}$ measurement data in South Korea and suggested $PM_{10}$ concentration metrics as long-term exposures for assessing health effects in cohort studies. We obtained hourly $PM_{10}$ data from the National Institute of Environmental Research for 2001~2012 in South Korea. We investigated spatial distribution of monitoring sites using the density and proximity in each of the 16 metropolitan cities and provinces. The temporal characteristics of $PM_{10}$ measurement data were examined by annual/seasonal/diurnal patterns across urban background monitoring sites after excluding Asian dust days. For spatial characteristics of $PM_{10}$ measurement data, we computed coefficient of variation (CV) and coefficient of divergence (COD). Based on temporal and spatial investigation, we suggested preferred long-term metrics for cohort studies. In 2010, 294 urban background monitoring sites were located in South Korea with a site over an area of $415.0km^2$ and distant from another site by 31.0 km on average. Annual average $PM_{10}$ concentrations decreased by 19.8% from 2001 to 2012, and seasonal $PM_{10}$ patterns were consistent over study years with higher concentrations in spring and winter. Spatial variability was relatively small with 6~19% of CV and 21~46% of COD across 16 metropolitan cities and provinces in 2010. To maximize spatial coverage and reflect temporal and spatial distributions, our suggestion for $PM_{10}$ metrics representing long-term exposures was the average for one or multiple years after 2009. This study provides the knowledge of all available $PM_{10}$ data measured at national regulatory monitoring sites in South Korea and the insight of the plausible longterm exposure metric for cohort studies.

• Journal of Korean Physical Therapy Science
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• v.18 no.1
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• pp.21-32
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• 2011

Objective: This study was conducted to describe physical therapists' attitudes and beliefs towards Korean Government's National Long Term Care Insurance Program implemented last July 2008. Design: A survey research. Methodology: Participants were 143 physical therapists working in General Hospitals or University Hospitals in Busan, Korea. Each of the participants completed a questionnaire which was comprised of 22 questions. Among the 22 questions, 7 of these were independent variables such as gender, age, career, etc. while 15 of these questions were dependent variables such as the subject's expectations and reactions on the said program, opinions of the participants on the impact of the program to old people's families and relatives, participant's sentiments on social effects of this program to the society, etc. Data collection was conducted from the $20^{th}$ of July to the $5^{th}$ of August, 2008. Data were analyzed by Chi-square test, frequency and cross tabs using SPSS/PC program. Results: Based on the survey conducted, it showed that 50.3% were female respondents, 53.8% were on their twenties, 31.5% of the total respondents were married and that a percentage of 82.4% had working experiences below 10 years. About 80.4% of respondents were satisfied of their jobs and 32.4%of the respondents graduated from three - year college degree, 49.3% of the respondents graduated from four-year college degree. 95.1% of the total respondents knew the existence of the national long term care insurance program of the government and almost 78% got the information of the said program via internet, news paper or T.V. About 86% of the respondents believe that there will be future improvements in the quality of life in Korea through the said program and 82% said that there will be an increase sense of responsibility among family members to take care of their old relatives. 67.2 % of respondents believe that problems regarding old people will be solved through the government's national long term care insurance program. In aspect of Physical Therapy, 50% of the respondents expected generation of more jobs especially to physical therapists and 95% of the respondents want to work in any position in the said program especially those are more experienced ones. Conclusion: Physical Therapists in Korea are aware of the existence of the National Long Term Care Insurance Program of the Korean Government. Based on the gathered results from the survey, many experienced physical therapists of the country wanted to acquire positions in the said program especially that their expertise are needed in the said field. Through this study, it is evident that many physical therapists of the country have positive vibes on the said program and are optimistic on the outcomes of the said insurance program.

• Journal of Chest Surgery
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• v.38 no.2 s.247
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• pp.139-145
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• 2005

Background: There were very few reports on long-term survival after coronary artery bypass graft (CABG) in this country. The aim of this study is to investigate the long-term result in patients undergoing CABG in the early period in this hospital. Material and Method: One-hundred and fourteen patients (male/female, 79/35) who had undergone CABG from December 1990 to December 1995 were identified. Most of the patients had undergone CABG using left internal thoracic artery and vein grafts under cardiopulmonary bypass and cardiopulmonary arrest, and the proximal and distal anastomoses of the grafts were performed during the single aortic cross clamping period. Result: During the mean follow-up period of $135.5\pm17.9$ months, 37 patients $(32.5\%)$ were dead and only 10 patients $(27\%)$ of them died of cardiac cause. Risk-unadjusted survival after CABG was $95.6\%,\;85.1\%,\;71.8\%,$ and $57.9\%$ at 1, 5, 10, and 13 years, respectively, and cardiac death-free survival was $97.4\%,\;94.5\%,\;92.1\%$, and $81.3\%$ at 1, 5, 10, and 13 years, respectively. Predictable factors of long-term survival were sex and age. Predictable factors of postoperative coronary angiography and intervention were hypertension, diabetes, and dyslipidemia. Conclusion: Long-term survival after CABG in the early operative period was comparable to the previous outcomes, and females showed the better long-term survival. Postoperative coronary intervention was more common in patients with preoperative dyslipidemia.

• Advances in pediatric surgery
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• v.19 no.2
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• pp.130-139
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• 2013

The application of laparoscopic techniques for the surgical management of Hirschsprung's disease is the recent trend. We described the surgical technique and postoperative long-term outcomes of the one-stage, laparoscopic-assiseted endorectal pull-through operation for Hirschsprung's disease. The technique uses three to four small abdominal ports. Laparoscopic mobilization of the sigmoid colon and rectum is performed and marginal artery-preserving colon pedicle is prepared. The rectal mobilization is performed using a transanal endorectal sleeve technique. The anastomosis is performed 0.5~1 cm above the dentate line. The age at surgery ranged from 6 days to 4 years. The average operative time was 144 minutes. Almost all of the patients passed stool and flatus within 36 hours of surgery. The average hospital stay after surgery was 6.5 days. Among 42 patients, 32 patients older than 3 years old were evaluated for function on defecation. All 32 patients have been continent, of those who needed laxatives were 11 (34.3%) due to constipation and overflow incontinence. Four children (12.5%) have remained dependent on laxatives. Laparoscopic-assisted endorectal pull-through operation for Hirschsprung's disease appears to be safe, provides the less pain, shorter time to full feeding, shorter hospital stay, and excellent cosmetic outcomes. Helping patients and parents ensure the quality of life, they should be provided with counseling, education, and longer-term follow-up care.