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Comparison of the Clinicopathologic Features and the Survival Rates in Young and Elderly Patients with Gastric Cancer (젊은 층과 노년층 위암 환자들의 임상병리학적 특성의 비교와 생존율)

  • Kim, Chan-Young;Yang, Doo-Hyun
    • Journal of Gastric Cancer
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    • v.6 no.4
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    • pp.257-262
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    • 2006
  • Purpose: We analyzed the clinicopathologic features, including treatment and outcome, and the survival rates between young and elderly patients with gastric cancer. Materials and Methods: Clinical information was reviewed for 1086 patients who had undergone a gastrectomy for gastric cancer during a 10-year period from 1990 to 1999, and the patients were assigned to one of two groups: the A group (<40 years of age, 91 patients) and the B group (${\geq}70\;years\;of\;age,\;85\;patients)$). Results: Compared to the B group, the A group had more females (47.3% vs 32.9%), a greater frequency of family history of cancer (15.4% vs 3.5%), and greater proportions of histologically poorly differentiated tumors (84.5% vs 40.2%) and Lauren diffuse-type tumors (69.1% vs 35.1%)(P<0.05). There was no difference in TNM stage. Cardiopulmonary co-morbidities were more in the B group, respectively, 1.1% (A group) and 11.8% (B group)(P<0.01), but the morbidity and the mortality were similar. Although there was no difference in curability, the B group underwent less aggressive operations in lymph-node dissection above D3 and had a shorter operation time, a smaller number of retrieved lymph nodes, and less adjuvant chemotherapy (P<0.001). However, there were no differences in the disease-specific 5-year survival rates, 67.6% and 67.0% respectively. Conclusion: Young and elderly patients with gastric cancer had different clinicopathological features. Especially, elderly patients underwent relatively less aggressive treatment. In spite of these facts, the outcome of treatment and the disease-specific survival rates were not different.

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A Study of the Effect of the KTX Mulgeum Station Stop on Railroad Users in Yangsan City (KTX 물금역 정차 확정이 양산시 철도 이용자에게 미치는 영향에 관한 연구)

  • Choi, Yang-Won;Jang, Jae-Suck;Suh, Jeong-Yeal
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.42 no.4
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    • pp.527-536
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    • 2022
  • The purpose of this study is to predict changing traffic environments and related economic effects by reflecting the changed KTDB and socio-economic indicators pertaining to Mulgeum station, a general railway stop, when it is confirmed as a KTX stop. To analyze the data of this study, socioeconomic indicators and the general status of transportation facility operations were investigated with reference to related statistical data, centered on the country overall and on Yangsan city in particular. In addition, we investigated and referenced the railroad facility construction plan and train operation plan, which are national high-level plans related to land development and transportation network construction. Currently, there are only ITX trains (4 times/day) and Mugunghwa trains (29 times/day) that stop at Mulgeum station in Yangsan, meaning that passengers cannot use KTX trains in the Yangsan area. In particular, the need for a KTX stop at Mulgeum station has been continuously raised because train users in the Yangsan area have inconvenient transportation in that they must travel 40 minutes to Ulsan station or 30 minutes to Gupo station to use the KTX. As a result of analyzing railroad transportation demand that will change in the future as the KTX stop at Mulgeum station is confirmed, the number of passengers boarding and arriving at Mulgeum station is predicted to be 1,674 passengers/day by 2025. In addition, the numbers of train passengers that are converted from Ulsan and Gupo stations due to the stop at Mulgeum station are predicted to be 594 passengers/day boarding and 562 passengers/day arriving by 2025. In the future, if Yangsan citizens use the KTX Mulgeum station, the access time to Mulgeum station can be shortened to 22 minutes from 65 minutes, and it is predicted that the inconvenience of transferring between railroads will be resolved, with the waiting time for transfers reduced by up to a maximum of 40 minutes. Therefore, the economic effect of creating a KTX stop at Mulgeum station was analyzed to be B/C=1.823 when general railroad operating costs are not taken into account and B/C=2.127 when general railroad operating costs are considered. In conclusion, when using KTX trains to visit the Seoul Metropolitan Area, it takes 2 hours and 43 minutes to use Mulgeum station without using Ulsan station or Gupo station, which is considered to be very effective for reducing travel times and improving the economic feasibility of this development; it is also expected that Yangsan city will be able to improve accessibility and mobility to the Seoul Metropolitan Area by breaking free from the disgrace of being a remote location given its link to KTX in the future.

A Study on Major Safety Problems and Improvement Measures of Personal Mobility (개인형 이동장치의 안전 주요 문제점 및 개선방안 연구)

  • Kang, Seung Shik;Kang, Seong Kyung
    • Journal of the Society of Disaster Information
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    • v.18 no.1
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    • pp.202-217
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    • 2022
  • Purpose: The recent increased use of Personal Mobility (PM) has been accompanied by a rise in the annual number of accidents. Accordingly, the safety requirements for PM use are being strengthened, but the laws/systems, infrastructure, and management systems remain insufficient for fostering a safe environment. Therefore, this study comprehensively searches the main problems and improvement methods through a review of previous studies that are related to PM. Then the priorities according to the importance of the improvement methods are presented through the Delphi survey. Method: The research method is mainly composed of a literature study and an expert survey (Delphi survey). Prior research and improvement cases (local governments, government departments, companies, etc.) are reviewed to derive problems and improvements, and a problem/improvement classification table is created based on keywords. Based on the classification contents, an expert survey is conducted to derive a priority improvement plan. Result: The PM-related problems were in 'non-compliance with traffic laws, lack of knowledge, inexperienced operation, and lack of safety awareness' in relation to human factors, and 'device characteristics, road-drivable space, road facilities, parking facilities' in relation to physical factors. 'Management/supervision, product management, user management, education/training' as administrative factors and legal factors are divided into 'absence/sufficiency of law, confusion/duplication, reduced effectiveness'. Improvement tasks related to this include 'PM education/public relations, parking/return, road improvement, PM registration/management, insurance, safety standards, traffic standards, PM device safety, PM supplementary facilities, enforcement/management, dedicated organization, service providers, management system, and related laws/institutional improvement', and 42 detailed tasks are derived for these 14 core tasks. The results for the importance evaluation of detailed tasks show that the tasks with a high overall average for the evaluation items of cost, time, effect, urgency, and feasibility were 'strengthening crackdown/instruction activities, education publicity/campaign, truancy PM management, and clarification of traffic rules'. Conclusion: The PM market is experiencing gradual growth based on shared services and a safe environment for PM use must be ensured along with industrial revitalization. In this respect, this study seeks out the major problems and improvement plans related to PM from a comprehensive point of view and prioritizes the necessary improvement measures. Therefore, it can serve as a basis of data for future policy establishment. In the future, in-depth data supplementation will be required for each key improvement area for practical policy application.

Short-Term Result of Endovenous 980-nm Diode Laser Treatment in Varicose Vein of Looter Extremities (하지정맥류에서 정맥내 980-nm 다이오드 레이저 치료의 단기결과)

  • Lee Seock Yeol;Song In Hag;Lee Seung Jin;Park Hyung Joo;Lee Cheol Sae;Lee Kihl Rho
    • Journal of Chest Surgery
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    • v.38 no.8 s.253
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    • pp.557-563
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    • 2005
  • Background: Recently 980-nm diode laser endovenous treatment was introduced and used as a method of treatment for varicose vein in lower extremities. The advantages of endovenous laser treatment are good cosmetic effects without incision and avoidance of complications associated with surgery. Therefore, we performed an endovenous laser treatment using a 980-nm diode laser and observed the effects and the efficiency of treatment. Material and Method: From October, 2003 to March, 2004, 55 patients (84 limbs) underwent endovenous laser treatment with a 980-nm diode laser. The effects of treatment, complications and recurrences were reviewed. Result The mean age of patients was 47.2 years old and the number of men and women were 2f and 35. In a total of 84 limbs, postoperative complications were transient ecchymosis(84 cases), local paresthesia (24 cases), local skin discolorization (6 cases), minimal burn (3 cases), and post operative phlebitis (1 cases). Adjuvant sclerotherapy was performed in 27 limbs and it was performed in varicose veins missed at operation and varicose veins remaining after endovenous laser treatment. In a total of 56 patients, 2 patients $(3.57\%)$ had recurrences after endovenous laser treatment and were treated with phlebectomy. Conclusion: Our findings demonstrated that 980-nm endovenous laser treatment had good cosmetic results with acceptable complications. This study was based on short-term results and long term follow-up is necessary to evaluate the accurate effects of treatment and recurrence. We think that multimodality treatment with endovenous laser treatment including phlebectomy or transilluminated powered phlebectomy can help decreasing of recurrence especially in patients with tortuous varicose cluster.

Neuroprotective Effect of Phenytoin and Hypothermia on a Spinal Cord Ischemic Injury Model in Rabbits (토끼의 척수 허혈 손상 모델에서 페니토인과 저체온의 신경 보호 효과의 비교)

  • Oh, Sam-Sae;Choe, Ghee-Young;Kim, Won-Gon
    • Journal of Chest Surgery
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    • v.41 no.4
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    • pp.405-416
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    • 2008
  • Background: Spinal cord ischemic injury during thoracic and thoracoabdominal aortic surgeries remains a potentially devastating outcome despite using various methods of protection. Neuronal voltage-dependent sodium channel antagonists are known to provide neuroprotection in cerebral ischemic models. This study was designed to compare the neuroprotective effects of phenytoin with those of hypothermia in a rabbit model of spinal cord ischemia. Material and Method: Spinal cord ischemia was induced in New Zealand white rabbits by means of infrarenal aortic cross clamping for 25 minutes. Four groups of 8 animals each were studied. The control group and the hypothermia group received retrograde infusion of saline only ($22^{\circ}C$, 2 mL/min); the normothermic phenytoin group and the hypothermicphenytoin group received retrograde infusion of 100 mg of phenytoin at different rectal temperatures ($39^{\circ}C$ and $37^{\circ}C$, respectively) during the ischemic period. The neurologic function was assessed at 24 and 72 hours after the operation with using the modified Tarlov criteria. The spinal cords were harvested after the final neurologic examination for histopathological examination to objectively quantify the amount of neuronal damage. Result: No major adverse effects were observed with the retrograde phenytoin infusion during the aortic ischemic period. All the control rabbits became severely paraplegic, Both the phenytoin group and the hypothermia group had a better neurological status than did the control group (p < 0.05). The typical morphological changes that are characteristic of neuronal necrosis in the gray matter of the control animals were demonstrated by means of the histopathological examination, whereas phenytoin or hypothermia prevented or attenuated these necrotic phenomena (p < 0.05). The number of motor neuron cells positive for TUNEL staining was significantly reduced, to a similar extent, in the rabbits treated with phenytoin or hypothermia. Phenytoin and hypothermia had some additive neuroprotective effect, but there was no statistical significance between the two on the neurological and histopathological analysis. Conclusion: The neurological and histopathological analysis consistently demonstrated that both phenytoin and hypothermia may afford significant spinal cord protection to a similar extent during spinal cord ischemia in rabbits, although no significant additive effects were noticed.

Acute Renal Failure after On-pump Coronary Artery Bypass Surgery (체외순환하 시행한 관상동맥우회술 후 발생한 급성신부전증)

  • Jin, Ung;Jo, Min-Seop;Park, Chan-Beom;Sa, Young-Jo;Kim, Chi-Kyung
    • Journal of Chest Surgery
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    • v.37 no.5
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    • pp.416-422
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    • 2004
  • Acute renal failure (ARF) is a common postoperative complication after the cardiac surgery. Postoperative ARF have various causes, and are combined with other complications rather than being the only a complication. It deteriorates the general condition of the patient, and makes it difficult to manage the combined complications by disturbing the adequate medication and fluid therapy. We have planned this study to evaluate the effects of postoperative ARF after the on-pump coronary artery bypass surgery (CABG) on the recovery of patients and identify the risk factors. Method and Material: We reviewed the medical records of patients who underwent CABG with cardiopulmonary bypass by a single surgeon from Jan. 2000 to Dec. 2002, We checked the preoperative factors; sex, age, history of previous serum creationism over 2.0 mg/㎗, preoperatively last checked serum creatinine, diabetes, hypertension, left ventricular ejection fraction, intraoperative factors; whether the operation is an emergent case or not, cardiopulmonary bypass time, aortic cross clamp time, the number of distal anastomosis, postoperative factors: IABP. Then we have studied the relations of these factors and the cases of postoperative peak serum creatinine over 2.0 mg/㎗. Result: There were 19 cases with postoperative peak serum creatinine over 2.0 mg/㎗ in a total 97 cases. Dialysis were done in 3 cases for ARF with pulmonary edema and severely reduced urine output. There were 8 cases (42.1%) with combined complications among the 19 patients. This finding showed a significant difference from the 5 cases (6,4%) in the patients whose creatinine level have not increased over 2.0 mg/㎗. The mortalities are different as 1.3% to 10.5%. The risk factors that are related with postoperative serum creatinine increment over 2.0 mg/㎗ are diabetes, the history of previous serum creatinine over 2.0 mg/㎗ and left ventricular ejection fraction. Conclusion: Postoperative ARF after the on-pump CABG is related with preoperative diabetes, the history of previous serum creatinine over 2,0 mg/㎗ and left ventricular ejection fraction. Postoperative ARF could De the reason for increased rate of complications and mortality after on-pump CABG. Therefore, in the patients with these risk factors, the efforts to prevent postoperative ARF like off-pump CABG should be considered.

Research on the Soul & Body Thought of 'Dong-Jin Northern & Southern Dynasty' (동진남북조시기(東晉南北朝時期) 형신문제(形神問題)의 초보적(初步的) 탐구(探究))

  • CHO, Won-il
    • The Journal of Korean Philosophical History
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    • no.23
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    • pp.275-294
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    • 2008
  • The specific concern of 'Xing'(形) & 'Shen'(神) theory is considering the body and the soul of human being. If either of the body and the soul including the life of human as of basic items is not existed, it may not seem to be alive. A great number of philosophers during 'Dong-Jin Northern & Southern Dynasty'(東晉南北朝) had the most active and furthest discussion throughout the history of China to study the concerns; Having a question such as "Where the body and the soul come out around us?", "What is the essence of complicated and delicate mental operation?" "Are there any relationships between the body and the soul?" and then "How do the human soul exist after death?" First, during 'Don-Jin' period as body and soul theory was based on 'Yin'(陰) and 'Yang'(陽). 'He Cheng Tian'(何承天) said that everything which was burn on earth should die because the soul couldn't stay the dead body longer. In the same age, 'Ming Fo Run'(明佛論) and 'Da Xing Run'(達性論) which denied that the soul couldn't exist forever were main topics of the discuss among the distinguished philosophers. Next, during 'Northern & Southern dynasty', body and soul theory was divided into two. First of all, body and soul of 'Heng Cun'(恒存) might be harmonized, however, that was not perfectly put together. Because, after human death, even if the body of human might be existed, the soul left elsewhere but always stayed around us. The body was the soul which meant that the soul was to the nature of the body and the body was to the usage of soul. Many philosophers insisted that nobody meant no soul according to 'Shen Bu Mie Run'(神不滅論) and 'Shen Mie Run'(神滅論) which was the main topic as an academic argument in those days. Finally, during Dong-Jin dynasty covered the significance of Body and Soul theory and analyzed the influence into the history of the history philosophy in china.

A Study on Detection Methodology for Influential Areas in Social Network using Spatial Statistical Analysis Methods (공간통계분석기법을 이용한 소셜 네트워크 유력지역 탐색기법 연구)

  • Lee, Young Min;Park, Woo Jin;Yu, Ki Yun
    • Journal of Korean Society for Geospatial Information Science
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    • v.22 no.4
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    • pp.21-30
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    • 2014
  • Lately, new influentials have secured a large number of volunteers on social networks due to vitalization of various social media. There has been considerable research on these influential people in social networks but the research has limitations on location information of Location Based Social Network Service(LBSNS). Therefore, the purpose of this study is to propose a spatial detection methodology and application plan for influentials who make comments about diverse social and cultural issues in LBSNS using spatial statistical analysis methods. Twitter was used to collect analysis object data and 168,040 Twitter messages were collected in Seoul over a month-long period. In addition, 'politics,' 'economy,' and 'IT' were set as categories and hot issue keywords as given categories. Therefore, it was possible to come up with an exposure index for searching influentials in respect to hot issue keywords, and exposure index by administrative units of Seoul was calculated through a spatial joint operation. Moreover, an influential index that considers the spatial dependence of the exposure index was drawn to extract information on the influential areas at the top 5% of the influential index and analyze the spatial distribution characteristics and spatial correlation. The experimental results demonstrated that spatial correlation coefficient was relatively high at more than 0.3 in same categories, and correlation coefficient between politics category and economy category was also more than 0.3. On the other hand, correlation coefficient between politics category and IT category was very low at 0.18, and between economy category and IT category was also very weak at 0.15. This study has a significance for materialization of influentials from spatial information perspective, and can be usefully utilized in the field of gCRM in the future.

Embolectomy of Arteries of Extremities -Clinical analysis of 26 cases (사지동맥의 색전제거술 -26례의 분석-)

  • 강종렬;구본일
    • Journal of Chest Surgery
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    • v.30 no.2
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    • pp.172-178
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    • 1997
  • We present a etrospective analysis of arterial embolectomies performed at the Inje University Seoul Paik Hospital. During the period of March 1987 Feburary 1996 twenty-six patients underwent embolectomies, eighteen patients were male and eight patients were female, mean age of patients was 56.8 years. Rest pain was the chief complaint in 24 patients, the remaining two patients complained of long term history of claudication after recovery of acute symtoms. But only 10 patients had sensBrylmotor symtoms. Heart was the most common source of embolization and frequent predisposing factor of embolism was ischemic heart disease in 8 cases and valvular heart disease in 11 cases. The sites of embolization were upper extremities artery in 6 cases, saddle embolism in 2 cases, lower extremities artery in 18 cases and the most common site of embolism was femoral artery in 1 1 cases. Preoperative angiography was taken in the diagnosis and planning of the embolectomy in 1) patients while in the other patient p eoperative angiography was not taken. Only two cases were operated within the golden period of 6 hours and other cases were operated in more than 6 hours after embolization. In all patients, the Fogarty embolectomy catheter was used without bypass surgery via bachial ateriotomy in the embolism of upper extremities artery, bilateral groin approaches in the saddle embolism and transfemoral approach in the embolism of lower extremities artery. However 3 patients were re-operated via transpopliteal approach in the distal poplitiotibial embolism. Eighteen patients received perioperative anticoagulation therapy by heparin or fraxiparine and wafarin was used in 17 patients at the time of discharge and the indication of anticogulation was patients of valvular heat disease andfor atrial fibrillation, peripheral artery atherosclerosis and recurrent embolism. Postoperative results of the embolectomy were as follows: fouteen pateints had excellent results, five cases had symtom improvement after re-operation, B. K. amputation in 1 case who had severe atherosclerosis of lower extremities, recurrent embolism in 1 case and death in 2 cases the cause of death were acute renal failure and cerebral artery embolism, respectively. The complications of the embolectomy were reperfusion syndrome, pseudoaneurysm and intimal dissection in one case each. Conclusively the problems of embolism is delayed diagnosis and increasing number of old aged patient who had suffered from ischemic heart diease. Preoperative angiography was not always needed for embol ectomy. Selective anticoagulation therapy can decrease incidence of re-embolism. In the distal poplitiotibial embolism, embolectomy of tibial artery was difficult.

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Analysis of revision anterior cruciate ligament reconstruction (전방 십자인대 재재건술의 분석)

  • Park, Chan-Hee;Song, Eun-Kyoo;Seon, Jong-Keun;Yim, Ji-Heoun;Kang, Kyung-Do;Lee, Tae-Min
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.10 no.2
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    • pp.47-53
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    • 2011
  • Purpose: As the number of the anterior cruciate ligament (ACL) reconstruction has increased, the incidence of revision of ACL reconstruction due to reconstruction failure has been also increased. Therefore, authors analyzed the reason of the failure of ACL reconstruction and the clinical result of the ACL revision. Materials and methods: From February 1998 to July 2010, we selected 36 cases which was followed at least 12months after the ACL reconstruction failure. Duration from reconstruction to revision, the average duration was 60 months (5~334) and on first reconstruction, we used allograft on 23 cases (63.9%) and autograft on 13 cases (36.1%). For the main symptom of ACL reconstruction failure, instability was the most common symptom, and 35 cases (97.5%) were undergone only one reconstruction and 1case (2.5%) was undergone two reconstruction. Clinical results were evaluated by Lysholm knee joint score, pivot shift test, and Telos device. Results: Average follow-up duration of the patients was 21 months (12~40), and the reason for the ACL reconstruction failure, trauma was most common by 19 cases (52.8%), malposition of the femoral tunnel was 13 cases (36.1%), malposition of the tibia tunnel was 1case (2.8%), and failure of osteointegration was 3 cases (8.4%). On performing the ACL revision, we used allograft on 34 cases (94%) and autograft on 2 cases (6%), and 21 cases accompanied injury of the meniscus (medial meniscus 14 cases, lateral meniscus 7 cases). Lysholm knee joint score was improved from 66.5 points, preoperatively to 92 points on last follow-up (p<0.01). In most cases, patients were satisfied (92%) with the operation results. Tegner activity score was also improved from 2.0 points preoperatively to 6.2 points on the last follow-up. On Lachman and pivot sift test, 33 cases and 30 cases were improved to grade I respectively, and on stability test using Telos device, the bilateral difference was improved from mean 15.5 mm preoperatively to 4.5 mm on the last follow-up. Conclusion: After 1 year follow-up, Revision of ACL had a little anterior instability but it showed satisfactory result on clinical result and patient's subjective satisfaction.

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