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Video-Assisted Thoracic Surgery Lobectomy for Non-Small Cell Lung Cancer: Experience of 133 Cases (폐암에서의 흉강경 폐엽절제술 치험 133예)

  • Kim, Hyeong-Ryul;Cho, Jeong-Su;Jang, Hee-Jin;Lee, Sang-Cheol;Choi, Eun-Suk;Jheon, Sang-Hoon;Sung, Soak-Whan
    • Journal of Chest Surgery
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    • v.42 no.5
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    • pp.615-623
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    • 2009
  • Background: We evaluated the feasibility and the efficacy of Video-Assisted Thoracic Surgery (VATS) lobectomy for treating patients with non-small cell lung cancer (NSCLC) and we compared the outcomes of VATS lobectomy with those of open lobectomy. Material and Method: From 2003 to March 2008, 133 NSCLC patients underwent VATS lobectomy. The patients were selected on the basis of having clinical stage I disease on the chest CT and PET scan. The outcomes of 202 patients who underwent open lobectomy (OL group) for clinical stage I NSCLC were evaluated to compare their results with those of the patients who underwent VATS lobectomy (the VL group). Result: The number of females and the number of patients with adenocarcinoma and stage IA disease were greater in VL group (p<0.05). There was no operative mortality or major complications in the VL group. Conversion to thoracotomy was needed in 8 cases (6%), which was mostly due to bleeding. The chest tube indwelling time and the length of the postoperative hospital stay were significantly shorter in the VL group (p<0.001). The number of dissected lymph nodes and the size of tumor were significantly smaller in the VL group (p<0.001). For the pathologic stage I patients, there was no significant difference in the three-year survival rates between the two groups (p=0.15). Conclusion: VATS lobectomy is a safe procedure with low operative mortality and morbidity. VATS lobectomy is feasible for early stage NSCLC and it provides outcomes that are comparable to those for open lobectomy. Further long-term data are needed.

Clinical Results alter Pulmonary Endarterectomy as a Curative Surgical Method in Chronic Thromboembolic Pulmonary Hypertension: an Approach to Operative Classification of Thromboembolic Disease (만성 폐동맥 색전증의 치료로서 내막제거술의 임상적 결과: 색전증 분류에 따른 접근)

  • Lim, Ju-Yong;Lee, Jae-Won;Kim, Jeong-Won;Jung, Sung-Ho;Je, Hyoung-Gon;Song, Hyun;Chung, Cheol-Hyun;Choo, Suk-Jung
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.591-597
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    • 2008
  • Background: Pulmonary endarterectomy is widely accepted as a treatment for chronic thromboembolic pulmonary hypertension. Based on our experiences, we sought to find ways to reduce perioperative complications and to improve surgical outcomes in patients undergoing pulmonary endarterectomy. Material and Method: This study was designed as a retrospective analysis of 20 patients with pulmonary hypertension who underwent pulmonary endarterectomy between January 1998 and March 2008. All patients presented with chronic dyspnea. Deep vein thrombosis (DVT) was the major cause of chronic pulmonary thromboembolism (55%). Seventeen patients (85%) underwent inferior vena cava (IVC) filter placement. Thirteen patients underwent surgery under total circulatory arrest, while the others underwent surgery while on low flow cardiopulmonary bypass. Concomitant tricuspid annuloplasty was done in 6 patients (66%) whose tricuspid regurgitation was as severe as grade IV/IV. The mean follow-up duration was $45{\pm}32$ months. Result: Using of University of California, San Diego (UCSD), thromboembolism classification, 4 patients (20%) were type 1, 8 patients (40%) were type II, and 8 patients (40%) were type III. Right ventricular systolic pressure was reduced significantly from $77{\pm}29$ mmHg to $37{\pm}19$ mmHg after pulmonary endarterectomy (p<0.001). The degree of tricuspid regurgitation and the NYHA functional class were all improved postoperatively. Reperfusion edema occurred in 7 cases (35%). The incidence of reperfusion edema was higher in the UCSD type III group than in the other group (25% vs 50%, p=0.25) and the length of postoperative intensive care unit stay was longer in type III group ($5{\pm}2$ days vs $9{\pm}7$ days, p=0.07). The early mortality rate was 10%, and the late mortality rate was 15% (n=3); one death was due to progression of underlying non-Hodgkin's lymphoma, and the other deaths were related to recurrent thromboembolism and persistent pulmonary hypertension, respectively. Conclusion: Pulmonary endarterectomy, as a curative surgical method for treating chronic thromboernbolic pulmonary hypertension, should be performed aggressively in patients diagnosed with chronic thromboembolic pulmonary hypertension, and an effort should be made to reduce the frequency of perioperative complications and to improve surgical outcomes.

Analysis of the Factors Relating Nutritional Status in Discharging of Leukemia Patients Receiving Chemotherapy (항암화학요법을 받고 있는 혈액암 환자의 퇴원시 영양 상태와 관련한 요인 분석)

  • So, Eun-Jin;Kim, Jee-Yeon;Jung, Su-Jin;Park, Sook
    • Journal of Nutrition and Health
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    • v.43 no.1
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    • pp.26-33
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    • 2010
  • This study was performed to investigate the changes of oral diet intake during the admission period and identify the factors related with nutritional status in discharging of leukemia patients. This is a retrospective cross sectional study on 46 leukemia patients receiving chemotherapy at the Catholic University of Korea Seoul St. Mary's Hospital from July to September 2009. The patients' charts were surveyed on the general characteristics and factors relating chemotherapy. The calorie count method was used to investigate diet intake during admission period. Multivariate logistic regression analysis was used to identify possible confounding factors. A p < 0.05 was considered statistically significant. The mean age was $42.8\;{\pm}\;14.6$ years and the average length of stay was $30.4\;{\pm}\;7.0$ days. The incidence of malnourished patients was 60.9% in discharging. There was a significant difference in chemotherapy sessions and chemotherapy period between well-nourished and malnourished patients. The average energy intake was 1,525.9 kcal in well-nourished patients and 1,143 kcal in malnourished patients, which was significant different. From repeated measures ANOVA test, the changes of oral intake during admission period were significant by groups. In addition, there were significant differences in oral intake according to each period between well-nourished and malnourished patients. In multivariate logistic regression analysis, both the ratio of total oral energy intake to recommended energy intake and chemotherapy sessions were significantly associated with nutritional status in discharging. The results of this study could be used to establish a protocol of nutritional management for leukemia patients receiving chemotherapy.

Relationship between job stress, health functional food selection attributes, and consumption values among workers for information technology in Gyeonggi area (경기지역 IT 분야 직장인의 직무스트레스, 건강기능식품 선택속성 및 소비가치의 관계)

  • Jung, Ji-Eun;Kim, Sung-Eun
    • Journal of Nutrition and Health
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    • v.53 no.1
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    • pp.54-67
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    • 2020
  • Purpose: This study examined the relationship between job stress, attributes of health functional food (HFF) selection, and consumption values for information technology (IT) workers, and analyzed the factors influencing the selection of HFF to improve health by making the right choice of HFFs. Methods: Three hundred forty IT workers in Gyeonggi area participated in the study. The participants were divided into low or high job stress group. The differences in participants' general characteristics, attributes of HFF selection, and HFF consumption values were investigated, and the mediating effects of HFF consumption values on the relationship between job stress levels and the HFF selection attributes were analyzed. Results: Job stress levels were high in those IT workers with a length of service < 5 years (p = 0.013). The group with lower job stress levels had a higher tendency to consider the ingredients contained in HFF products (p < 0.001), and their efficacy (p = 0.047). They also showed greater emotional value for a sense of security from consuming HFFs to stay healthy (p = 0.047). The group with higher job stress levels had greater epistemic value in that their choice of HFFs differentiated them from the other workers (p = 0.036). Higher job stress was associated with less consideration of the intrinsic attributes such as ingredients and efficacy of the HFF selection attributes (p = -0.113), emotional value of the HFF consumption values (p = -0.136), and the functional value such as practicality, price, and safety (p = -0.134). The job stress level influenced the intrinsic attributes through the functional and emotional values, demonstrating that the functional and emotional values had appropriate mediating effects on the relationship between job stress levels and intrinsic attributes. Conclusion: Education needs to be provided for workers to relieve job stress and improve the functional and emotional values, which contributes to choosing the appropriate HFFs.

Perinatal outcomes according To chorionicity in Twin Gestations (쌍생아 임신의 융모막과 주산기 결과)

  • Choi, Eun-Jin;Yun, Hyun-Jin;Hyh, Jae-Won;Hong, Yong-Hong
    • Neonatal Medicine
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    • v.15 no.1
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    • pp.67-74
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    • 2008
  • Purpose : The purpose of this study was to assess the natural history and perinatal outcomes of twin gestations according to chorionicity. Methods : We retrospectively reviewed the medical records of 99 monochorionic (MC) and 206 dichorionic (DC) twin gestations delivered at Il Sin Christian Hospital in Busan between January 2002 and December 2007. The incidences of twin-to-twin transfusion syndrome (TTS) and selective intrauterine growth restriction (sIUGR), as well as perinatal morbidity and mortality, were evaluated. Results : MC twins had a lower gestational age (35.7 vs. 36.6 weeks, P=0.03) at birth and a higher incidence of intrauterine fetal loss (10% vs. 1.5%, P<0.001) than DC twins. The incidence of intrauterine fetal loss was higher in MC sIUGR than in DC sIUGR (19% vs. 2.5%, P=0.025) twins. The number of admissions to the neonatal intensive care unit (NICU; 31% vs. 16%, P=0.042), and the incidence of periventricular leukomalacia (7% vs. 0%, P=0.031), and respiratory distress syndrome with surfactant treatment (27% vs. 11%, P=0.049) were higher in MC than DC twins. The incidences of sIUGR and TTS were 21 and 9% among the MC twins. The incidences of intrauterine fetal loss were higher in MC twins with TTS [6 of 9 (67%)] or sIUGR [4 of 21 (19%)] than uncomplicated MC twins (P<0.001). The frequency of admission to the NICU (P=0.001), the length of hospital stay (P=0.033), the prevalence of periventricular leukomalacia (P=0.011), and intraventricular hemorrhage (P=0.007) were also higher in MC with TTS or sIUGR than in uncomplicated MC twins. Conclusion : The incidence of neonatal complications was higher in MC twins, especially those gestations complicated by TTS or sIUGR.

Study of the Korean Americans Housewives' Knowledge of Korean Festival Foods (재미 한인 주부들의 한국 명절음식에 대한 인식)

  • 심영자;김정선
    • Korean journal of food and cookery science
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    • v.14 no.2
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    • pp.148-158
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    • 1998
  • This study was to investigate the knowledge of Korean festival foods and the acculturation of American main traditional occasions among Korean American housewives residing in the New York and New Jersey area. Out of 400 questionnaires, the 271 respondents were taken. Of the respondents, 77.1% demonstrated the interest in Korean festival foods. The most important Korean festivals were Chusuk (52.0%), Sulnal(46.9%) and Daeborum (1.1%). In order to make the Korean festival foods to be international foods, the most vital factor was taste and flavor (39.5%), cooking method (34.7%), preservation (10.3%), sanitation (8.1%) and nutrition (7.4%). American Thanksgiving Day was the most important occasion among the Korean American housewives. The factors that keep the American traditional occasions were related to whether the respondents had an occupation or the length of stay in the U.S.A. But in case of Korean festival foods, the factors cannot be applied. On the contrary, they do still keep the tradition and the interest of Korean festival foods in U.S.A. As a result of that, the Korean festival foods in the U.S.A. are systemized for the preservation and popularization for the coming Korean generation.

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A New Single Cross Maize Hybrid for Grain and Silage, 'Pyeongangok' (내도복 다수성 종실 및 사일리지 옥수수 신품종 '평강옥')

  • Son, Beom-Young;Baek, Seong-Bum;Kim, Jung-Tae;Lee, Jin-Seok;Hwang, Jong-Jin;Kwon, Young-Up;Ji, Hee-Jung;Huh, Chang-Suk;Park, Jong-Yeol
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.32 no.3
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    • pp.203-208
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    • 2012
  • Pyeongangok, a new single cross variety, is an yellow dent maize hybrid (Zea mays L.) developed by the maize breeding team at the National Institute of Crop Science (NICS), RDA in 2011. This hybrid, which has a high yield of grain and dry matter, was produced by crossing two inbred lines, KS160 and KS155. KS160 is the seed parent and KS155 is the pollen parent of Pyeongangok. Silking date of Pyeongangok is 2 days earlier than that of check hybrid, Jangdaok, and equal to that of another check hybrid, Kwangpyeongok. Plant height of Pyeongangok is longer than that of Jangdaok and similar to that of Kwangpyeongok. Ear numbers per 100 plants of Pyeongangok is more than that of Jangdaok. Ear length of Pyeongangok is shorter than that of Jangdaok. 100 seeds weight of Pyeongangok is lighter than that of Jangdaok. Ear rate of Pyeongangok is lower than that of Kwangpyeongok. Stay-green of Pyeonganok is not greatly different with that of Kwangpyeongok. It has moderately resistance to southern corn leaf blight (Bipolaris maydis), black streaked dwarf virus (BSDV) and corn borer. It has strong resistance to northern corn leaf blight (Exserohilum turcicum). It has resistance to lodging. Pyeongangok was evaluated for the yields of grain and dry matter at four locations from 2009 to 2011. The yield of Pyeongangok in grain was 7.66 ton/ha. The yield of Pyeongangok in dry matter was 19.80 ton/ha. The yield of Pyeongangok in total digestible nutrient (TDN) was 13.32 ton/ha. Seed production of Pyeongangok has gone well due to a good match during crossing between the seed parent, KS160, and the pollen parent, KS155, in Yeongwol.

Validation of initial nutrition screening tool for hospitalized patients (입원 환자용 초기 영양검색도구의 타당도 검증)

  • Kim, Hye-Suk;Lee, Seonheui;Kim, Hyesook;Kwon, Oran
    • Journal of Nutrition and Health
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    • v.52 no.4
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    • pp.332-341
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    • 2019
  • Purpose: Poor nutrition in hospitalized patients is closely linked to an increased risk of infection, which can result in complications affecting mortality, as well as increased length of hospital stay and hospital costs. Therefore, adequate nutritional support is essential to manage the nutritional risk status of patients. Nutritional support needs to be preceded by nutrition screening, in which accuracy is crucial, particularly for the initial screening. To perform initial nutrition screening of hospitalized patients, we used the Catholic Kwandong University (CKU) Nutritional Risk Screening (CKUNRS) tool, originally developed at CKU Hospital. To validate CKUNRS against the Patient-Generated Subjective Global Assessment (PG-SGA) tool, which is considered the gold standard for nutritional risk screening, results from both tools were compared. Methods: Nutritional status was evaluated in 686 adult patients admitted to CKU Hospital from May 1 to July 31, 2018 using both CKUNRS and PG-SGA. Collected data were analyzed, and the results compared, to validate CKUNRS as a nutrition screening tool. Results: The comparison of CKUNRS and PG-SGA revealed that the prevalence of nutritional risk on admission was 15.6% (n = 107) with CKUNRS and 44.6% (n = 306) with PG-SGA. The sensitivity and specificity of CKUNRS to evaluate nutritional risk status were 98.7% (96.8 ~ 99.5) and 33.3% (28.1 ~ 39.0), respectively. Thus, the sensitivity was higher, but the specificity lower compared with PG-SGA. Cohen's kappa coefficient was 0.34, indicating valid agreement between the two tools. Conclusion: This study found concordance between CKUNRS and PG-SGA. However, the prevalence of nutritional risk in hospitalized patients was higher when determined by CKUNRS, compared with that by PG-SGA. Accordingly, CKUNRS needs further modification and improvement in terms of screening criteria to promote more effective nutritional support for patients who have been admitted for inpatient care.

The Current Status of Utilization of Palliative Care Units in Korea: 6 Month Results of 2009 Korean Terminal Cancer Patient Information System (말기암환자 정보시스템을 이용한 우리나라 암환자 완화의료기관의 이용현황)

  • Shin, Dong-Wook;Choi, Jin-Young;Nam, Byung-Ho;Seo, Won-Seok;Kim, Hyo-Young;Hwang, Eun-Joo;Kang, Jina;Kim, So-Hee;Kim, Yang-Hyuck;Park, Eun-Cheol
    • Journal of Hospice and Palliative Care
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    • v.13 no.3
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    • pp.181-189
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    • 2010
  • Purpose: Recently, health policy making is increasingly based on evidence. Therefore, Korean Terminal Cancer Patient Information System (KTCPIS) was developed to meet such need. We aimed to report its developmental process and statistics from 6 months data. Methods: Items for KTCPIS were developed through the consultation with practitioners. E-Velos web-based clinical trial management system was used as a technical platform. Data were collected for patients who were registered to 34 inpatient palliative care services, designated by Ministry of Health, Welfare, and Family Affairs, from $1^{st}$ of January to $30^{th}$ of June in 2009. Descriptive statistics were used for the analysis. Results: From the nationally representative set of 2,940 patients, we obtained the following results. Mean age was $64.8{\pm}12.9$ years, and 56.6% were male. Lung cancer (18.0%) was most common diagnosis. Only 50.3% of patients received the confirmation of terminal diagnosis by two or more physicians, and 69.7% had an insight of terminal diagnosis at the time of admission. About half of patients were admitted to the units on their own without any formal referral. Average and worst pain scores were significantly reduced after 1 week when compared to those at the time of admission. 73.4% faced death in the units, and home-discharge comprised only 13.3%. Mean length of stay per admission was $20.2{\pm}21.2$ days, with median value of 13. Conclusion: Nationally representative data on the characteristics of patients and their caregiver, and current practice of service delivery in palliative care units were obtained through the operation of KTCPIS.

Comparative Analysis of Laparoscopy-assisted Gastrectomy versus Open Gastrectomy (복강경 보조 위절제술과 개복 위절제술의 비교 분석)

  • Lim, Jung Taek;Kim, Byung Sik;Jeong, Oh;Kim, Ji Hoon;Yook, Jeong Hwan;Oh, Sung Tae;Park, Kun Choon
    • Journal of Gastric Cancer
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    • v.7 no.1
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    • pp.1-8
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    • 2007
  • Purpose: There has been increased the number of early gastric cancer and laparoscopy-assisted gastrectomy (LAG), due to early detection through mass screening program. We started the LAG in April 2004 and performed 119 cases of gastric cancer in 2005, so we report a surgical outcome compared with that of open gastrectomy (OG). Materials and Methods: 119 patients underwent LAG in 2005, and for open group, 126 patiens of early gastric cancer were selected sequentially from January 2005 to March 2005. We compared clinicopathologic characteristics, postoperative courses and complications between two groups. Results: There was no significant difference between age, a length of hospital stay, distal resection margin and a number of retrived lymph nodes. The operation time was longer in LAG group (239.2 vs 123.3 mins, P<0.001) and a diet progression was faster in LAG group (first flatus: 3.05 vs 3.70 days, SOW: 2.86 vs 3.22 days, liquid diet: 3.87 vs 4.19 days, soft diet: 4.84 vs 5.26 days, P<0.001). But there was no difference statistically in postoperative discharge date (7.73 vs 8.25 days, P=0.229). The additional requirement of analgesic injection was less frequent in LAG group (2.97 vs 4.92 times, P<0.001). The harvested lymph nodes were similar in both groups (23.9 vs 23.1, P=0.563). A complication rate was lower in LAG group (4.9% vs 9.5%), but there was no statistical significance (P=0.179). There was no mortality in both groups and no conversion to open gastrectomy in the LAG group. Conclusion: LAG can be performed safely and accepted in view of curative procedure in treatment of early gastric cancer. But we need the follow up of long-term period to evaluate the survival rate and recurrence, and a prospective randomized controlled study should be done to establish that LAG will be a standard operation for early gastric cancer.

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