• Journal of Gastric Cancer
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• v.8 no.2
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• pp.97-103
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• 2008

Purpose: Radical surgery is the standard therapy for patients with resectable cardia cancer. In the case of type II disease with esophageal invasion, a transhiatal extended radical total gastrectomy is needed or a gastroesophagectomy through an abdomino-thoracotomy, depending on the extent of the esophageal invasion. We analyzed the indications and outcome of left colon interposition as an esophageal substitution. Materials and Methods: Between 1 January 1994 and 31 December 2006, 10 patients underwent left colon interposition after gastroesophagectomy through an abdomino-thoracotomy or the tanshiatal approach for type II cardia cancer at the Department of surgery, Yonsei University College of Medicine. The outcomes of these patients were reviewed and compared, with those who underwent a Roux-en-Y, by gender and age matched analysis, retrospectively. Results: There were nine males and one female with a mean age of 52.5 (range, 16~72). The operation time was $449.00{\pm}87.39minutes$. The mean distance between the proximal resection margin and the cancer was $6.56{\pm}3.65cm$; the maximum size of the tumor was $9.90{\pm}3.97cm$. These measures differed significantly from patients who underwent Roux-en-Y. The patients had a double primary cancer in the cardia and esophagus. There were no events of colon necrosis. However, a pneumothorax occurred in one patient (10%) and a proximal anastomotic stricture occurred in one patient. There were no reports of heartburn, regurgitation, thoracic or epigastric fullness, and one patient even gained weight, 16 kg. Conclusion: Colon interposition after esophagogastrectomy was safe and effective and should be considered as an additional surgical option for locally advanced type II cardia cancer patients with esophageal invasion.

• Journal of Gastric Cancer
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• v.6 no.2
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• pp.109-113
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• 2006

Purpose: Various minimally invasive surgical techniques, such as an endoscopic mucosal resection and a laparoscopic gastrectomy, are becoming common practice for some cases of early gastric cancer (EGC) defined in terms of the depth of invasion being limited to the mucosa or submucosa. However, there are rare cases of early gastric cancer with massive lymph-node metastasis. Materials and Methods: From 6 university hospitals of Korea, 2,772 EGC cases were resected during the various period of analysis (1,432 cases of mucosal cancer and 1,340 of submucosal cancer). Results: As control data, we used the data from a single institute, CHA University Hospital. There were nine cases of early gastric cancer (9/2,772, 0.32%) with N3 lymph node metastasis defined by more than 15 lymph nodes being metastasized according to the UICC-TNM classification (pT1N3, stage IV). Two cases were mucosal cancer (2/1,432, 0.1 4%), and seven cases were submucosal cancer (7/1,340, 0.52%). Metastasized lymph nodes varied in number from 18 to 52. There were three male and six female patients with a mean age of 57. This is a totally reversed sex ratio compared to the usual gastric cancer or EGC. Among the total of 9 EGC patients, there were 5 who had superficial spreading carcinomas with surface areas larger than $25\;cm^2$. This is a significantly higher proportion compared to the general EGC population. When we compared the tumor size according to the LN status, the N3 group was definitely larger than the other groups. 78% of the pT1N3 cases showed lymphatic invasion, which is very high compared to the 4.7% in general EGC cases. Among the 9 cases, 6 patients had too short a follow-up period to evaluate the correct prognosis, but there was one patient with a non-curative resection and two patients with early recurrence. Although the sample size is small and the follow-up period is short, we can expect a very poor prognosis when we consider the common prognosis of EGC that is widely known and accepted. Conclusion: From these results, we can a conclude that the risk factors for pT1N3 gastric cancer are female patients, submucosal invasion, larger tumor size, and lymphatic invasion. However rare, the existence of pT1N3 gastric cancer needs to be taken into consideration, especially during the diagnosis. Furthermore, minimally invasive treatment for EGC needs to be chosen with great precaution. Since the prognosis of pT1N3 gastric cancer is expected to be poor, aggressive adjuvant chemotherapy may be necessary. (J Korean Gastric Cancer Assoc 2006;6:109-113)

• Journal of agricultural medicine and community health
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• v.27 no.1
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• pp.115-123
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• 2002

Objective: The aim of this study was to evaluate the patterns of helicopter emergency medical services (HEMS) in Ullung Island. Methods : The authors reviewed the records from emergency room diaries and the lists of helicopter transfers in the Ullung Public Health Medical Center over the 5-year period from Jan 1, 1997 to Dec 31, 2001. Results : One hundred thirteen cases were transferred by helicopters in 88 flights. According to year, the number of flights was 13(14.8%) and the number of cases was 15(13.3%) in 1997; 17(19.3%) and 21(18.6%) in 1998; 18(20.5%) and 20(17.7%) in 1999; 17(19.3%) and 20(17.7%) in 2000; and 23(26.1%) and 37(32.7%) in 2001. According to the kind of helicopter, the number of flights was 46(52.3%) and the number of cases was 60(53.1%) by Maritime police; and 19(21.6%) and 28(25.1%) by 119 rescue. According to time zone, there were no night flights. According to sex and age, there were 75 male cases(66.4%) and 28 cases(28.3%) of patients aged sixty years and over. The number of flights was 11(12.5%) and the number of cases was 15(13.3%) in November; 10 flights(11.4%) and 14 cases(12.4%) in March; and 7 cases(8.0%) in each of September, October and April. The most common season of helicopter transfer cases was autumn. According to transfer area, there were 48 cases (42.5%) in Pohang city, Gyeonsangbukdo; 35(31.0%) in Gangnung city, Gangwondo; and 17(15.0%) in Daegu metropolitan city. According to condition, there were 27 cases(23.9%) of cerebro-vascular accident, 13(11.5%) of fracture and 11(9.7%) of head injury. According to admission department, there were 42 cases(37.2%) in Neurosurgery, 21(18.6%) in Internal Medicine and 13(11.5%) in Orthopedic Surgery. According tothe Korea Standard Classification of Disease(3-KSCD), circulatory systemic disease(IX) and injury, intoxication and others (XIX) were the two most frequent categories with 34 cases(30.1%) each, followed by digestive system disease (XI) with 23 cases(20.4%). Conclusions : HEMS in Ullung Island leave much to be desired. Helicopters cannot make a night flight and are not equipped with medical facilities. HEMS in islands such as Ullung Island are essential. We hope that night flights, equipment-monitoring systems for emergency patients in the helicopters, and a law related to HEMS in the island will all be established.

• Childhood Kidney Diseases
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• v.3 no.1
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• pp.80-87
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• 1999

Purposes : Renal involvement is a potentially serious complication of systemic lupus erythematosus (SLE). There have been only few studies of lupus nephritis in pediatric age. In this study, the clinical manifestations, pathologic findings, response to treatment, and clinical course of lupus nephritis in children were analyzed. And the results will provide basic data for future nation-wide prospective multi-center study. Methods . The medical records of 46 children clinically and pathologically diagnosed to have lupus nephritis at Seoul National University Children's Hospital during 1986 to 1997 were analyzed retrospectively. Results : 1) The median age of diagnosis of lupus nephritis was 12.8 years ($2\;years\~\;15year$ 8months), and the sex ratio was 1:2.5. 2) FANA($85.7\%$), anti-ds-DNA antibody ($78.0\%$), and malar rash ($60.8\%$) were the most common findings among the classification criteria by ARA Decreased C3 was detected in $88.9\%$ of patients. 3) Hematuria ($87.0\%$) was the most common renal symptom, and WHO class IV lupus nephritis was identified in 41 cases by renal biopsy. 4) In most of patients, the disease activity was controlled relatively well with a single or combined therapy of prednisolone, azathioprine, or cyclophosphamide. The response revealed no difference according to the mode of treatment. 5) Infection, especially of Varicella-Zoster virus and candida, was the most common complication during the disease course. Conclusion : The renal involvement was noted in $87.0\%$ of childhood SLE, and $89.1\%$ of renal lesions was WHO class IV lupus nephritis known to associated with poor long-term prognosis. So, aggressive treatment using immunosuppressants in the early disease course may be helpful to increase long-term prognosis of lupus nephritis. A prospective multi-center study is necessary to analyze the therapeutic efficacy of various treatment modalities.

• Journal of Chest Surgery
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• v.36 no.1
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• pp.15-20
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• 2003

Myasthenia gravis is a rare autoimmune disease involving acetylcholine receptor and its autoantibody on neuromuscular junction. The methods of treatment are medical treatment and surgical thymectomy. In this paper we analyzed the result of thymectomy and the factors affecting the postoperative symptom improvement. Material and method : This study obtained medical records of 37 patients who received the thymectomy for myasthenia gravis from March 1986 to December 1998. Result Out of 37 cases, 21 cases(57%) showed improvement, of which 8 cases (50%) in the group of thymoma(n=16), and 13 cases (62%) in the group of thymic hyperplasia(n=21) showed the improvement of symptoms. Postoperative complications were respiratory insufficiency due to aggravation of symptoms after operation, including tracheal intubation for ventilator support in 9 cases, pneumonia in 3 cases, pneumothorax in 2 cases and left vocal cord palsy in 1 case. There was one postoperative mortality. The relation between postoperative improvement and sex(P=0.3222), age(P=0.7642), thymic pathologic variants,(P=0.4335) and classification of thymoma(P=0.20) showed no statistically significant correlation. However, the lower grade of preoperative symptoms can predict the lower grade of postoperative symptoms significantly(P=0.0032). Follow up study to 36 postoperative survivors was performed in October 2002 based on the out-patient records and call with patients. Out of 36 cases, 33 cases(91.7%) could be investigated and 3 cases could not. Mean follow up period was 83.2 months. Out of 33 cases, 25 cases(75.8%) showed symptomatic improvement, of which 8 cases(53.3%) in the group of thymoma(n=15) and 17 cases(94.4%) in the group of thymic hyperplasia(n=18) showed the improvement of$\boxUl$ symptoms. Conclusion : In myasthenia gravis, thymectomy showed the good improvement, and more important factor affecting the improvement of symptoms was the grdae of preoperative symptoms. Also midterm and long term follow up results showed good symptomatic improvement.

• Childhood Kidney Diseases
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• v.7 no.1
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• pp.23-29
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• 2003

Purpose : This study was performed to determine the natural history of histologically confirmed IgA nephropathy in pediatric patients who presented with hematuria and proteinuria. Patients and Methods : We reviewed the clinical course of 57 patients diagnosed with IgA nephropathy at the age of 15 years or younger from 1981 to 2000. All patients presented with hematuria or minimal proteinuria($<40\;mg/m^2/day$) and had normal renal function and blood pressure at the time of renal biopsy. Based on the clinical and pathological findings at the time of diagnosis, we sought for complications of IgA nephropathy such as heavy proteinuria(${\ge}40\;mg/m^2/day$), hypertension, and chronic renal failure. Results : The mean age at presentation was $9.5{\pm}2.8$ years(4 to 15 years) and 42(74%) were male. Isolated gross hematuria was observed in 20 patients(35%), microscopic hematuria in 3(5%), minimal proteinuria in 4(7%), both gross hematuria and minimal proteinuria in 15(26%), and both microscopic hematuria and minimal proteinuria in 15(26%). During a median follow-up of $7.0{\pm}3.5$ years, 38(67%) had complete resolution of hematuria and proteinuria, 12(21%) had persistently abnormal urinalysis without development of adverse events. Only 7(12%) developed adverse events : 4(7%) developed severe proteinuria, 1(2%) became hypertensive, and 2(3%) developed Impaired renal function. By univariate analysis using the chisquare test, the age at presentation(>10 years)(P<0.01) and poor histological classes of the Lee or Haas classification at onset(P<0.05) were significantly correlated with adverse events, whereas sex and clinical signs at onset were less concordant. Conclusion : We can conclude that the prognosis of IgA nephropathy diagnosed in early childhood is better and a good correlation exists between the clinical manifestations of this disease and the histological classes.

• Sleep Medicine and Psychophysiology
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• v.8 no.2
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• pp.121-128
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• 2001

Objectives: In narcoleptic patients diagnosed with ICSD (international classification of sleep disorders, 1990) criteria, nocturnal polysomnography, and MSLT (multiple sleep latency test), we tried to find characteristic features of quantitative electroencephalography (QEEG) in a wakeful state. Methods: We compared eight drug-free narcoleptic patients with sex- and age-matched normal controls, using computerized electroencephalographic mapping technique and spectral analysis. Absolute power, relative power, interhemispheric asymmetry, interhemispheric and intrahemispheric coherence, and mean frequency in each frequency band (delta, theta, alpha and beta) were measured and analyzed. Results: Compared with normal controls, narcoleptic patients showed decrease in monopolar interhemispheric coherence of alpha frequency bands in occipital ($O_1/O_2$), parietal ($P_3/P_4$), and temporal ($T_5/T_6$) areas and beta frequency band in the occipital ($O_1/O_2$) area. Monopolar intrahemispheric coherences of alpha frequency bands in left hemispheric areas ($T_3/T_5$, $C_3/P_3$ & $F_3/O_1$) decreased. Decrease of monopolar interhemispheric asymmetry of delta frequency band in the occipital ($O_1/O_2$) area was also noted. The monopolar absolute powers of beta frequency bands decreased in occipital ($O_2,\;O_z$) areas. Conclusion: Decreases in coherences of narcoleptic patients compared with normal controls may indicate fewer posterior neocortical interhemispheric neuronal connections, and fewer left intrahemispheric neuronal connections than normal controls in a wakeful state. Therefore, we suggest that abnormal neurophysiological sites of narcolepsy may involve complex areas such as neocortex and subcortex as well as the brainstem.

• Tuberculosis and Respiratory Diseases
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• v.41 no.3
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• pp.262-269
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• 1994

Background : A clinical study was carried out on 153 new cases with small cell lung cancer registered at Presbyterian Medical Center, Chonju during the 7 years from 1986 to 1992. They were analyzed by sex and age distribution, symptoms and signs, classification of stage and site and its treatments. Especially, an effort was made to compare the overall survival time between limited stage and extensive stage. Methods : Among 806 lung cancer patients diagnosed by biopsy or cytologic evaluation for the 7 years, 153 patients was shown small cell lung cancer. These 153 cases was analyzed retrospectivery through patient's records, letters or telephones. Results : The results of evaluation of small cell lung cancer are as follows. Over 85 percent of the small cell lung cancer patients were over 50 years of age and prominent clinical features were cough(86.3%), sputum(75.8%) and dyspnea(54.9%). One hundred and five patients(68.7%) was staged to have limited stage. Mean survival time of the chemotherapy and chemoradiotherapy in limited stage has significant difference and its survivals are 5.3 months and 15.0 months. Patients whose disease was staged as limited, regardless of whether or not chemotherapy was administered, had a median survival time of 10.9 months, compared with 4.8 months for those with extensive stage. Conclusion : Lung cancer is one of the malignant diseases tend to increase gradually in Korea and proven to be the most common cancer next to the gastric cancer among various cancers in males found at the Presbyterian Medical Center in the past seven years. This report is a retrospective view of the clinical therapeutic results of the small cell lung cancer patients. Especially at the limited stage, the combined therapy revealed higher survival rate than the chemotherapy alone. For a more accurate evaluation. a prospective view, without any bias, of patients selected at random is needed.

• Radiation Oncology Journal
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• v.14 no.2
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• pp.95-103
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• 1996

Purpose : A retrospective analysis for patients with oropharyngeal carcinoma who were treated with radiation was performed to assess the results of treatment and patterns of failure, and to identify the factors that might influence survival. materials and methods : From March 1985 through June 1993, 53 patients with oropharyngeal carcinoma were treated with either radiation therapy alone or combination of neoadjuvant chemotherapy and radiation therapy at the Department of Radiation Oncology, Kyungpook National University Hospital. Patients' ages ranged from 31 to 73 years with a median age of 54 years. There were 47 men and 6 women, Forty-two Patients ($79.2\%$) had squamous cell carcinoma, 10 patients ($18.9\%$) had undifferentiated carcinoma and 1 patient ($19\%$) had adenoid cystic carcinoma. There were 2 patients with stage I, 12 patients with stage II, 12 Patients with stage III and 27 patients with stage IV. According to the TNM classification, patients were distributed as follows: T1 7, T2 28, T3 10, T4 7, TX 1, and N0 17, Nl 13, N2 21, N3 2. The primary tumor sites were tonsillar region in 36 patients ($67.9\%$), base of the tongue in 12 patients ($22.6\%$), and soft palate in 5 patients ($9.4\%$). Twenty-five patients were treated with radiation therapy alone and twenty-eight Patients were treated with one to three courses of chemotherapy followed by radiation therapy. Chemotherapeutic regimens used were either CF (cisplatin and 5-fluorouracil) or CVB (cisplatin, vincristine and bleomycin). Radiation therapy was delivered 180-200 cGy daily, five times a week using 6 MV X-ray with or without 8-10 MeV electron beams A tumor dose ranged from 4500 cGy to 7740 cGy with a median dose of 7100 cGy. The follow-up time ranged from 4 months to 99 months with a median of 21 months. Results : Thirty-seven patients ($69.8\%$) achieved a CR (complete response) and PR (partial response) in 16 patients ($30.2\%$) after radiation therapy. The overall survival rates were $47\%$ at 2 years and $42\%$ at 3 years, respectively. The median survival time was 23 months. Overall stage (p=0.02) and response to radiation therapy (p=0.004) were significant prognostic factors for overall survival. The 2-year disease-free survival rate was $45.5\%$. T-stage (p=0.03), N-stage (p=0.04) and overall stage (P=0.04) were significant prognostic factors for disease-free survival. Age, sex, histology, primary site of the tumor, radiation dose, combination of chemotherapy were not significantly associated with disease-free survival. Among evaluable 32 Patients with CR to radiation therapy, 12 patients were considered to have failed Among these, 8 patients failed locoregionally and 4 Patients failed distantly. Conclusion : T-stage, N-stage and overall stage were significant prognostic factors for disease-free survival in the treatment of oropharyngeal cancer Since locoregional failure was the predominant pattern of relapse, potential methods to improve locoregional control with radiation therapy should be attempted. More controlled clinical, trials should be completed before acceptance of chemotherapy as a part of treatment of oropharyngeal carcinoma.

• Journal of Intelligence and Information Systems
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• v.25 no.1
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• pp.179-196
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• 2019

Recently, the "Smart Consumer" has been emerging. He or she is increasingly inclined to search for and purchase products by taking into account personal judgment or expert reviews rather than by relying on information delivered through manufacturers' advertising. This is especially true when purchasing cosmetics. Because cosmetics act directly on the skin, consumers respond seriously to dangerous chemical elements they contain or to skin problems they may cause. Above all, cosmetics should fit well with the purchaser's skin type. In addition, changes in global cosmetics consumer trends make it necessary to study this field. The desire to find one's own individualized cosmetics is being revealed to consumers around the world and is known as "Finding the Holy Grail." Many consumers show a deep interest in customized cosmetics with the cultural boom known as "K-Beauty" (an aspect of "Han-Ryu"), the growth of personal grooming, and the emergence of "self-culture" that includes "self-beauty" and "self-interior." These trends have led to the explosive popularity of cosmetics made in Korea in the Chinese and Southeast Asian markets. In order to meet the customized cosmetics needs of consumers, cosmetics manufacturers and related companies are responding by concentrating on delivering premium services through the convergence of ICT(Information, Communication and Technology). Despite the evolution of companies' responses regarding market trends toward customized cosmetics, there is no "Intelligent Data Platform" that deals holistically with consumers' skin condition experience and thus attaches emotions to products and services. To find the Holy Grail of customized cosmetics, it is important to acquire and analyze consumer data on what they want in order to address their experiences and emotions. The emotions consumers are addressing when purchasing cosmetics varies by their age, sex, skin type, and specific skin issues and influences what price is considered reasonable. Therefore, it is necessary to classify emotions regarding cosmetics by individual consumer. Because of its importance, consumer emotion analysis has been used for both services and products. Given the trends identified above, we judge that consumer emotion analysis can be used in our study. Therefore, we collected and indexed data on consumers' emotions regarding their cosmetics experiences focusing on consumers' language. We crawled the cosmetics emotion data from SNS (blog and Twitter) according to sales ranking ($1^{st}$ to $99^{th}$), focusing on the ample/serum category. A total of 357 emotional adjectives were collected, and we combined and abstracted similar or duplicate emotional adjectives. We conducted a "Consumer Sentiment Journey" workshop to build a "Consumer Sentiment Dictionary," and this resulted in a total of 76 emotional adjectives regarding cosmetics consumer experience. Using these 76 emotional adjectives, we performed clustering with the Self-Organizing Map (SOM) method. As a result of the analysis, we derived eight final clusters of cosmetics consumer sentiments. Using the vector values of each node for each cluster, the characteristics of each cluster were derived based on the top ten most frequently appearing consumer sentiments. Different characteristics were found in consumer sentiments in each cluster. We also developed a cosmetics experience pattern map. The study results confirmed that recommendation and classification systems that consider consumer emotions and sentiments are needed because each consumer differs in what he or she pursues and prefers. Furthermore, this study reaffirms that the application of emotion and sentiment analysis can be extended to various fields other than cosmetics, and it implies that consumer insights can be derived using these methods. They can be used not only to build a specialized sentiment dictionary using scientific processes and "Design Thinking Methodology," but we also expect that these methods can help us to understand consumers' psychological reactions and cognitive behaviors. If this study is further developed, we believe that it will be able to provide solutions based on consumer experience, and therefore that it can be developed as an aspect of marketing intelligence.