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The Prognostic Significance of the Number of Resected Lymph Nodes in Gastric Cancer Patients (근치 절제술을 시행한 위암에서 절제림프절 수의 임상적 의의)

  • Kim, Se-Jin;Jang, You-Jin;Kim, Jong-Han;Park, Sung-Soo;Park, Seong-Heum;Kim, Seung-Ju;Mok, Young-Jae;Kim, Chong-Suk;Ahn, Hyong-Gin
    • Journal of Gastric Cancer
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    • v.9 no.4
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    • pp.246-255
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    • 2009
  • Purpose: The objectives of this study were to investigate the impact of the number of resected lymph nodes on the survival of gastric cancer patients who underwent curative resection, and to evaluate the cut-off values that can have an influence on survival on the tumor stage-stratified analysis. Materials and Methods: The subjects were 949 gastric cancer patients who underwent curative resection at Korea University Medical Center from 1992 to 2002. They were classified according to the depth of tumor invasion, and the influence of the number of resected lymph nodes on survival was investigated. The cut-off value for the number of resected lymph nodes was determined as the smallest value that showed a significant survival difference. Results: The tumor size, location, lymph node stage, the number of metastatic lymph nodes and the number of resected lymph nodes were significantly different according to the tumor stage. The average number of resected lymph nodes was about 39, and it showed linear correlation with the number of metastatic lymph nodes. On the Cox proportional hazard model, the cut-off values of the number of resected lymph nodes, as corrected by the number of metastatic lymph nodes, was 14 for all the patients, 15 for the pT1 patients, 28 for the pT2 patients and 37 for the pT3 patients, respectively. Conclusion: Retrieving a number of lymph nodes that is more than the cut-off value could improve the survival of gastric cancer patients. Surgeons should also make efforts to perform an exact and thorough D2 lymph node dissection. Therefore, we urge surgeons to perform D2 dissection and pathologists should examine an certain exact number of lymph nodes.

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Identification of LEF1 as a Susceptibility Locus for Kawasaki Disease in Patients Younger than 6 Months of Age

  • Kim, Hea-Ji;Yun, Sin Weon;Yu, Jeong Jin;Yoon, Kyung Lim;Lee, Kyung-Yil;Kil, Hong-Ryang;Kim, Gi Beom;Han, Myung-Ki;Song, Min Seob;Lee, Hyoung Doo;Ha, Kee Soo;Sohn, Sejung;Ebata, Ryota;Hamada, Hiromichi;Suzuki, Hiroyuki;Kamatani, Yoichiro;Kubo, Michiaki;Ito, Kaoru;Onouchi, Yoshihiro;Hong, Young Mi;Jang, Gi Young;Lee, Jong-Keuk;The Korean Kawasaki Disease Genetics Consortium
    • Genomics & Informatics
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    • v.16 no.2
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    • pp.36-41
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    • 2018
  • Kawasaki disease (KD) is an acute febrile vasculitis predominately affecting infants and children. The dominant incidence age of KD is from 6 months to 5 years of age, and the incidence is unusual in those younger than 6 months and older than 5 years of age. We tried to identify genetic variants specifically associated with KD in patients younger than 6 months or older than 5 years of age. We performed an age-stratified genome-wide association study using the Illumina HumanOmni1-Quad BeadChip data (296 cases vs. 1,000 controls) and a replication study (1,360 cases vs. 3,553 controls) in the Korean population. Among 26 candidate single nucleotide polymorphisms (SNPs) tested in replication study, only a rare nonsynonymous SNP (rs4365796: c.1106C>T, p.Thr369Met) in the lymphoid enhancer binding factor 1 (LEF1) gene was very significantly associated with KD in patients younger than 6 months of age (odds ratio [OR], 3.07; $p_{combined}=1.10{\times}10^{-5}$), whereas no association of the same SNP was observed in any other age group of KD patients. The same SNP (rs4365796) in the LEF1 gene showed the same direction of risk effect in Japanese KD patients younger than 6 months of age, although the effect was not statistically significant (OR, 1.42; p = 0.397). This result indicates that the LEF1 gene may play an important role as a susceptibility gene specifically affecting KD patients younger than 6 months of age.

A Longitudinal Trend Analysis in Scientific Knowledge Achievement Progress (초.중.고 학생들의 과학 지식 성취 수준 추이 분석을 위한 종단적 연구)

  • Kwon, Jae-Sool;Choi, Byung-Soon;Kwon, Chi-Soon;Yang, Il-Ho;Lee, Gyoung-Ho;Kim, Ji-Na
    • Journal of The Korean Association For Science Education
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    • v.19 no.2
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    • pp.185-193
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    • 1999
  • The long term trend of studensts' science achievement is a very important factor to check the effectiveness of science educational policy. However, up to date no such effort to understand the trend of Korean students' science achievement has been put into action. Recently, the Science Education Center in Korea National University of Education has been attempted to collect nation wide data for students' science achievement. The first part of the effort was to develop item pools. This study was the second part to collect nation wide data and to check any change during the two year time interval. In this study, the item pools developed by Kwon et. al.(1998) were used with some modification. The data were collected two times; February 1997 and March 1999. The subjects collected nationally were 8,766 students in 1997 and were 4,398 in 1999. The subjects were collected randomly but stratified by region and sex. As the results, the trends of achievement change during the two years were different from elementary to high school. The achievement scores were decreased in elementary schools and increased in high school. In case of middle schools, the change was not significant. However, even in elementary schools the knowledge on theory was increased significantly while knowledge on facts and principles were decreased. In contrast, the knowledge on fact showed the most increase in high schools. In this study, the data were analysed in light of region, sex, behavioral objective levels(ability) and context of test items. The science achievement monitoring system developed by the Science Education Center in Korea National University of Education can be an effective tool for monitoring students' achievement on the national level.

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Diagnostic Value of Serum CYFRA 21-1 in Lung Cancer (폐암에서 혈중 CYFRA 21-1의 진단적 가치)

  • Yoon, Hyun-Dae;Kim, Ki-Deok;Chung, Jin-Hong;Lee, Hyung-Woo;Lee, Kwan-Ho;Lee, Hyun-Woo;Cho, Ihn-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.2
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    • pp.149-155
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    • 1995
  • Background: Cytokeratin 19 is 40KD acidic molecule whose distribution is restricted to simple or pseudo-stratified epithelia, such as the epithelial layer of the bronchial tree. Immunohistochemical study have shown that cytokeratin 19 is overexpressed in lung carcinoma tissue. An immunoradiometric assay, CYFRA 21-1 has been developed using two monoclonal antibody, BM 19-21 and KS 19-1, reactive to different epitopes on cytokeratin 19. We studied the diagnostic value of CYFRA 21-1 in lung cancer. Method: The serum CYFRA 21-1 level using immunoradiometric kit(ELSA-CYFRA 21-1) was measured in 54 patients who admit to Yeungnam University Hospital from April, 1993 to August, 1994. Lung cancer group was 39 primary lung cancer patients(19 patients with squamous cell carcinoma, 11 patients with adenocarcinoma and 9 patients with small cell carcinoma). Control group was 15 patients with non malignant lung diseases(8 patients with pulmonary tuberculosis, 3 patients with chronic obstructive pulmonary disease, 2 patients with pneumonia and 2 patients with chronic obstructive pulmonary disease combined with pulmonary tuberculosis). Results: The mean serum value of CYFRA 21-1 was $20.2{\pm}4.7ng/ml$ in squamous cell carcinoma, $7.2{\pm}1.6ng/ml$ in adenocarcinoma and $15.5{\pm}4.7ng/ml$ in non-small cell lung cancer. The serum value of CYFRA 21-1 in control group was $1.7{\pm}0.5ng/ml$. All of the serum values of 3 histologic types were significantly higher than that of control group(p<0.01). The serum value of CYFRA 21-1 of squamous cell carcinoma was significantly higher than that of adenocarcinoma(p <0.05). Serum value of CYFRA 21-1 in small cell lung cancer was $2.9{\pm}0.9ng/ml$ and not significantly different compared with control group. Using cut off value of 3.3ng/ml, sensitivity and specificity was 11.1%, 65.2% in small cell lung cancer, 70.0%, 62.5% in non-small cell lung cancer, 73.7%, 75% in squamous cell carcinoma and 63.6%, 78.9% in adenocarcinoma, respectively. Conclusion: The serum levels of CYFRA 21-1 may be useful in diagnosis of non-small cell lung carcinoma, especially in squamous cell carcinoma with its high specificity.

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Cigarette Smoking and Polymorphism of the Paraoxonase 1 Gene as Risk factors for Lung Cancer (폐암발생의 위험인자로서 흡연과 Paraoxonase 1 유전자 다형성)

  • Lee, Chul-Ho;Lee, Kye Young;Hong, Yun-Chul;Choe, Kang-Hyeon;Kim, Yong-Dae;Kang, Jong-Won;Kim, Heon;Hong, Jang Soo
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.5
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    • pp.490-497
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    • 2005
  • Background : The paraoxonase enzyme plays a significant role in the detoxification of various organophosphorous compounds in mammals, and paraoxonase (PON) 1 is one of the endogenous free-radical scavenging systems in the human body. In this study, we investigated the interaction between cigarette smoking and the genetic polymorphism of PON1 with lung cancer in Korean males. Methods : Three hundred thirty five patients with lung cancer and an equal number of age-matched controls were enrolled in this study. Every subject was asked to complete a questionnaire concerning their smoking habits and alcohol drinking habits. A 5' exonuclease assay (TaqMan) was used to genotype the PON1 Q192R polymorphism. The effects of smoking habits and drinking habits, the PON1 Q192R polymorphism and their interactions were statistically analyzed. Results : Cigarette smoking and the Q/Q genotype of PON1 were significant risk factors for lung cancer. Individuals carrying the Q/Q genotype of PON1 were at a higher risk for lung cancer as compared with those individuals carrying the Q/R or R/R genotype (odds ratio, 2.84; 95% confidence interval, 1.69 - 4.79). When the groups were further stratified by the smoking status, the Q/Q PON1 was associated with lung cancer among the current or ex-smokers (odds ratio, 2.56; 95% confidence interval, 1.52 - 4.31). Current smokers or ex-smokers who had the Q/Q genotype showed an elevated risk for lung cancer (odds ratio: 15.50, 95% confidence interval: 6.76 - 35.54) as compared with the group of subjects who never smoked, and had the Q/R or R/R genotype. The odds ratios (95% confidence interval) of smokers with the PON1 Q/Q type compared to the nonsmokers with the PON1 Q/R or R/R type were 53.77 (6.55 - 441.14) for squamous cell carcinoma, 6.25 (1.38 - 28.32) for adenocarcinoma, and 59.94 (4.66 - 770.39) for small cell carcinoma, and these results were statistically significant. Conclusion : These results suggest that cigarette smoking and the PON1 Q/Q genotype are risk factors for lung cancer. The combination of cigarette smoking and the PON1 Q/Q genotype significantly increased the lung cancer risk irrespective of the histologic type of cancer.

Attempted Suicides in South Korea : A Multi-Center Analysis of Causes, Methods, and Psychiatric Diagnoses of Suicidal Attempters in 2013 (응급실 방문 자살기도자들의 기도 원인, 방법, 정신과적 진단에 대한 다기관 분석)

  • Kim, Hyeyoung;Kim, Bora;Kang, Seung-Gul;Kim, Moon-Doo;Kim, Min-Hyuk;Kim, Soo In;Kim, Jae Min;Moon, Eunsoo;Ahn, Joon-Ho;Lee, Kyung-Uk;Lee, Sang-Hyuk;Lee, Seung Jae;Jeong, Seong Hoon;Chung, Young-Chul;Jung, Hee Yeon;Ju, Gawon;Cha, Boseok;Ha, Tae Hyon;Ahn, Yong-Min
    • Korean Journal of Biological Psychiatry
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    • v.22 no.4
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    • pp.187-194
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    • 2015
  • Objectives To examine direct causes of attempted suicides, methods adopted to commit suicide, and psychiatric diagnoses among suicide attempters in South Korea. Methods A total of 1359 suicide attempters who had visited emergency department of 17 medical centers due to suicide attempt from May 2013 to Nov 2013 were interviewed using semi-structured questionnaires. Results Psychiatric symptoms were the most common cause of suicide attempts (62.2%), followed by interpersonal relationships (24.4%). Women attempted suicide more often for interpersonal reasons, whereas men were more likely to do so for financial and job-related reasons. Half of participants (55.8%) attempted suicide by drug intoxication, which was more prevalent among females and those who had previous history of psychiatric disease or previous suicide attempt. Men were more likely to use more lethal methods such as pesticide poisoning and gas inhalation than women. Pesticide poisoning was also prevalent among the elderly group and the rural population. Near ninety-five percent (94.5%) of participants received a psychiatric diagnosis : the most frequent diagnosis was depressive disorder. Conclusions This is the first nationwide study of cases of attempted suicide. When stratified by age groups, gender, urbanicity, living alone or not, presence of physical illness, previous psychiatric history, and previous suicide attempt, there were significant differences with respect to causes, methods of attempted suicides and psychiatric diagnoses of suicide attempters.

Sedimentary Facies and Evolution of the Cretaceous Deep-Sea Channel System in Magallanes Basin, Southern Chile (마젤란 분지의 백악기 심해저 하도 퇴적계의 퇴적상 및 진화)

  • Choe, Moon-Young;Sohn, Young-Kwan;Jo, Hyung-Rae;Kim, Yea-Dong
    • Ocean and Polar Research
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    • v.26 no.3
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    • pp.385-400
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    • 2004
  • The Lago Sofia Conglomerate encased in the 2km thick hemipelagic mudstones and thinbedded turbidites of the Cretaceous Cerro Toro Formation, southern Chile, is a deposit of a gigantic submarine channel developed along a foredeep trough. It is hundreds of meters thick kilometers wide, and extends for more than 120km from north to south, representing one of the largest ancient submarine channels in the world. The channel deposits consist of four major facies, including stratified conglomerates (Facies A), massive or graded conglomerates (Facies B), normally graded conglomerates with intraformational megaclasts (Facies C), and thick-bedded massive sandstones (Facies D). Conglomerates of Facies A and B show laterally inclined stratification, foreset stratification, and hollow-fill structures, reminiscent of terrestrial fluvial deposits and are suggestive of highly competent gravelly turbidity currents. Facies C conglomerates are interpreted as deposits of composite or multiphase debris flows associated with preceding hyperconcentrated flows. Facies D sandstones indicate rapidly dissipating, sand-rich turbidity currents. The Lago Sofia Conglomerate occurs as isolated channel-fill bodies in the northern part of the study area, generally less than 100m thick, composed mainly of Facies C conglomerates and intercalated between much thicker fine-grained deposits. Paleocurrent data indicate sediment transport to the east and southeast. They are interpreted to represent tributaries of a larger submarine channel system, which joined to form a trunk channel to the south. The conglomerate in the southern part is more than 300 m thick, composed of subequal proportions of Facies A, B, and C conglomerates, and overlain by hundreds of m-thick turbidite sandstones (Facies D) with scarce intervening fine-grained deposits. It is interpreted as vertically stacked and interconnected channel bodies formed by a trunk channel confined along the axis of the foredeep trough. The channel bodies in the southern part are classified into 5 architectural elements on the basis of large-scale bed geometry and sedimentary facies: (1) stacked sheets, indicative of bedload deposition by turbidity currents and typical of broad gravel bars in terrestrial gravelly braided rivers, (2) laterally-inclined strata, suggestive of lateral accretion with respect to paleocurrent direction and related to spiral flows in curved channel segments around bars, (3) foreset strata, interpreted as the deposits of targe gravel dunes that have migrated downstream under quasi-steady turbidity currents, (4) hollow fills, which are filling thalwegs, minor channels, and local scours, and (5) mass-flow deposits of Facies C. The stacked sheets, laterally inclined strata, and hollow fills are laterally transitional to one another, reflecting juxtaposed geomorphic units of deep-sea channel systems. It is noticeable that the channel bodies in the southern part are of feet stacked toward the east, indicating eastward migration of the channel thalwegs. The laterally inclined strata also dip dominantly to the east. These features suggest that the trunk channel of the Lago Sofia submarine channel system gradually migrated eastward. The eastward channel migration is Interpreted to be due to tectonic forcing imposed by the subduction of an oceanic plate beneath the Andean Cordillera just to the west of the Lago Sofia submarine channel.

Associations Between Three Polymorphisms in the Interleukin-4 Receptor Gene and Risk of Cancer: a Meta-analysis

  • Wang, Jia-Yi;Zhou, Yu-Qiao;Li, Xiao-Xu;Jin, Xin;Wang, Li-Li;Lei, Lei;Zhou, Yu;Lu, Jiang;Zeng, Xin;Dan, Hong-Xia;Liao, Ga;Chen, Qian-Ming
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.12
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    • pp.6227-6232
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    • 2012
  • Interleukin-4 receptor (IL-4R) gene single nucleotide polymorphisms (SNPs) are implicated in cancer development. However, results from the published reports have remained inconclusive. The objective of this study was to conduct a meta-analysis investigating the association between polymorphisms in IL-4R gene and cancer risk. Pubmed, EMBASE and China National Knowledge Infrastructure (CNKI) were searched for case-control studies published up to October 30, 2012 that investigated IL-4R polymorphisms and cancer risk. Odds ratios (ORs) and 95% confidence intervals (CIs) were used to evaluate the strength of any associations. Three IL-4R polymorphisms (Q576R, rs1801275; I75V, rs1805010; S503P, rs1805015) in 21 case-control studies were analyzed. Our meta-analysis indicated that these three polymorphisms are not associated with cancer risk when all studies were pooled together. In the subgroup analysis by tumor site, the results showed that Q576R G allele carriers were associated with a significantly decreased cervical cancer risk (recessive model: OR = 0.77, 95%CI = 0.60-0.98; homozygote comparison: OR = 0.76, 95%CI = 0.58-0.98). I75V G allele carriers were associated with a decreased risk of renal cancer (dominant model = 0.71, 95%CI = 0.57-0.89, heterozygote comparison: OR = 0.69, 95%CI = 0.55-0.87). When stratified by ethnicity, Q576R G allele carriers were associated with a decreased cancer risk in Caucasians (dominant model: OR = 0.90, 95%CI = 0.83-0.98; heterozygote comparison: OR = 0.89, 95%CI = 0.82-0.98). I75V G allele carriers were associated with a decreased cancer risk in Asians (heterozygote comparison: OR = 0.76, 95%CI = 0.62-0.94). S503P C allele carriers were also associated with a decreased cancer risk in Asians (CC VS TT: OR = 0.29, 95%CI = 0.08-0.99). Our results suggest that Q576R, I75V and S503P may be associated with a decreased cancer risk for certain types of cancers and in some specific ethnic groups. Future case-control studies with large sample size are needed to evaluate these associations in detail.

The Health Status of Rural Farming Women (농촌여성(農村女性)의 건강실태(健康實態)에 관한 연구(硏究))

  • Park, Jung-Eun
    • Journal of agricultural medicine and community health
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    • v.15 no.2
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    • pp.97-106
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    • 1990
  • 1. Background Women's health and their involvement in health care are essential to health for everyone. If they are ignorant, malnourished or over-worked, the health &-their families as well as their own health will suffer. Women's health depends on broad considerations beyond medicine. Among other things, it depends upon their work in farming. their subordination to their families, their accepted roles, and poor hygiene with poorly equipped housing and environmental sanitation. 2. Objectives and Contents a. The health status of rural women : physical and mental complaints, experience of pesticides intoxication, Farmer's syndrome, experiences of reproductive health problems. b. participation in and attitudes towards housework and farming c. accessibility of medical care d. status of maternal health : fertility, family planning practice. induced abortion, and maternal care 3. Research method A nationwide field survey, based on stratified random sampling, was conducted during July, 1986. Revised Cornell Medical index(68 out of 195 items). Kawagai's Farmers Syndrome Scale, and self-developed structured questionnaires were used to rural farming wives(n=2.028). aged between 26-55. 4. Characteristics of the respondents mean age : 40.2 marital status : 90.8% married mean no. of household : 4.9 average years of education : 4.7 yrs. average income of household : \235,000 average years of residence in rural area : 36.4 yrs average Working hours(household and farming) : 11 hrs. 23 min 5. Health Status of rural women a. The average number of physical and mental symptoms were 12.4, 4.7, and the rate of complaints were 22.1%, 38.8% each. revealing complaints of mental symptomes higher than physical ones. b. 65.4% of rural women complained of more than 4 symptoms out of 9, indicating farmer's syndrome. 11.9 % experienced pesticide overdue syndrome c. 57.6% of respondents experienced women-specific health problems. d. Age and education of respondents were the variables which affect on the level of their health 6. Utilization of medical services a. The number of symptoms and complaints of respondents were dependent on the distance to where the health-care service is given b. Drug store was the most commonly utilized due to low price and the distance to reach. while nurse practitioners were well utilized when there were nurse practitioner's office in their villages. c. Rural women were internalized their subordination to husbands and children, revealing they are positive(93%) in health-care demand for-them but negative(30%) for themselves d. 33.0% of respondents were habitual drug users, 4.5% were smokers and 32.3% were alcohol drinkers. and 86.3% experienced induced-abortion. But most of them(77.6%) knew that those had negative effects on health. 7. Maternal Health Care a. Practice rate of contraception was 48.1% : female users were 90.9% in permanent and 89.6% in temporary contraception b. Induced abortions were taken mostly at hospital(86.3%), while health centers(4.7%), midwiferies(4.3%). and others(4.5%) including drug stores were listed a few. The repeated numbers of induced abortion seemed affected on the increasing numbers of symptoms and complaints. c. The first pre-natal check-up during first trimester was 41.8%, safe delivery rate was 15.6%, post-natal check-up during two months after delivery. Rural women had no enough rest after delivery revealing average days of rest from home work and farming 8.3 and 17.2. d. 86.6% practised breast feeding, showing younger and more educated mothers depending on artificial milk 8. Recommendations a. To lessen the multiple role over burden housing and sanitary conditions should be improved, and are needed farming machiner es for women and training on the use of them b. Health education should begin at primary school including health behavior and living environment. c. Women should be encouraged to become policy-makers as well as administrators in the field of women specific health affairs. d. Women's health indicators should be developed and women's health surveillance system too.

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Changes of Seasonal and Vertical Water Quality in Soyang and Paldang River-reservoir System, Korea (소양호와 팔당호 수질의 수직 및 계절적 변화)

  • Kim, Jong-Min;Park, Jun-Dae;Noh, Hye-Ran;Han, Myung-Soo
    • Korean Journal of Ecology and Environment
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    • v.35 no.1 s.97
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    • pp.10-20
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    • 2002
  • Changes of seasonal and vertical water quality was analyzed with physico-chemical data from Soyang and Paldang river-reservoir system in Korea during the 1996 to 1998. In Soyang river-reservoir system, the water column was well stratified, which narrow epilimnion layer of 5 to 10 m depth in spring to summer enlarged gradually about 40 m depth in fall as going to times. In contrast, metalimnion layer tended to be narrow during the same period. Water temperature of hypolimnion was maintained about $5^{\circ}C$ continuously throughout the year. DO of the epilimnion layer was supersaturated from spring to summer, however, it was decreased to 75% at the epilimnion layer and $45{\sim}50%$ at the hypolimnion layer at the late fall. The lowest conductivity of below $50\;{\mu}S/cm$ was observed at the metalimnion layer during thesummer to fall. In Paldang river-reservoir system, the water column wag well mixed layer throughout the year, although water temperature was changed seasonally from $5^{\circ}C$ in February to $28^{\circ}C$ in July. Water temperature between upper and lower layer was different about $5^{\circ}C$ from late spring (May) to early fall (September). DO was over and less saturated in upper and lower layer during the early summer to early fall, respectively. Conductivity was decreased to $90\;{\mu}S/cm$ in lower layer of below $4{\sim}5\;m$ depth during the late spring to early fall and that of upper layer of above 10 m depth decreased to about $100\;{\mu}S/cm$ during the late fall (November) and early spring (March). Retention time of Soyang river-reservoir system was much longer than that of Paldang river-reservoir system. Chlorophyll a, T-N and T-P concentration in Paldang river-reservoir system were higher than that of Soyang river-reservoir system by a factor of 2.7, 1.2 and 2.6, respectively. Algal blooming was deeply affected by the nutrients than the retention time.