Feasibility and Effects of a Postoperative Recovery Exercise Program Developed Specifically for Gastric Cancer Patients (PREP-GC) Undergoing Minimally Invasive Gastrectomy

Cho, In,Son, Younsun,Song, Sejong,Bae, Yoon Jung,Kim, Youn Nam,Kim, Hyoung-Il,Lee, Dae Taek,Hyung, Woo Jin The Korean Gastric Cancer Association 2018 Journal of gastric cancer Vol.18 No.2

Purpose: Exercise intervention after surgery has been found to improve physical fitness and quality of life (QOL). The purpose of this study was to investigate the feasibility and effects of a postoperative recovery exercise program developed specifically for gastric cancer patients (PREP-GC) undergoing minimally invasive gastrectomy. Materials and Methods: Twenty-four patients treated surgically for early gastric cancer were enrolled in the PREP-GC. The exercise program comprised sessions of In-hospital Exercise (1 week), Home Exercise (1 week), and Fitness Improvement Exercise (8 weeks). Adherence and compliance to PREP-GC were evaluated. In addition, body composition, physical fitness, and QOL were assessed during the preoperative period, after the postoperative recovery (2 weeks after surgery), and upon completing the PREP-GC (10 weeks after surgery). Results: Of the 24 enrolled patients, 20 completed the study without any adverse events related to the PREP-GC. Adherence and compliance rates to the Fitness Improvement Exercise were 79.4% and 99.4%, respectively. Upon completing the PREP-GC, patients also exhibited restored cardiopulmonary function and muscular strength, with improved muscular endurance and flexibility (P<0.05). Compared to those in the preoperative period, no differences were found in symptom scale scores measured using the European Organization for Research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire (QLQ-C30) and Quality of Life Questionnaire-Stomach Cancer-Specific Module (QLQ-STO22); however, higher scores for global health status and emotional functioning were observed after completing the PREP-GC (P<0.05). Conclusions: In gastric cancer patients undergoing minimally invasive gastrectomy, PREP-GC was found to be feasible and safe, with high adherence and compliance. Although randomized studies evaluating the benefits of exercise intervention during postoperative recovery are needed, surgeons should encourage patients to participate in systematic exercise intervention programs in the early postoperative period (Registered at the ClinicalTrials.gov, NCT01751880).

Thermocouple을 이용한 Buchanan Plugger 표면의 온도상승 분석

조진숙,황윤찬,김선호,황인남,최보영,정영진,정우남,오원만 전남대학교 치의학연구소 2003 구강과학 Vol.15 No.4

This study was performed to confirm the actual temperature rise on the surface of Buchanan plugger by evaluating the temperature rise on the surface of it, the peak temperature of pluggers of various size using thermocouple. The heat carrier system 'System B Heatsource' (Model 1005, Analytic Technologies, USA) and the Buchanan pluggers of F, FM, M and ML sizes are used for this study. The temperature was set to 200 which Dr. Buchanan's "Continuous wave of condensation" technique recommended on digital display and the power level on it was set to 10. The touch mode was used. Five thermocouples were placed in direct contact with the surface of each size of Buchanan's pluggers at 1 ㎜ increments from the tip to the 4 ㎜ length of shank. Each thermocouple was secured with cyanoacrylate adhesive and orthodontic resin block. The two wire leads of each thermocouple were connected to the appropriate channels of Data Logger. This was configured to simultaneously record input from the five thermocouples. The heat control spring was touched for 1, 2, 3, 4 and 5 seconds, and the temperature rise on the surface of the pluggers were measured at 1 sec intervals for more than 5 seconds with an accuracy of 0.01. Ten trials was determined for each plugger. The average of temperature rise and standard deviation was calculated for each size of plugger. The data were statistically analyzed by one-way ANOVA to determine their significance. The results as follows. 1. The position at which the temperature peaked was approximately at 1∼2㎜ far from the tip of Buchanan plugger (p<0.01). 2. The peak temperature was 215.25±2.28℃ in F plugger, 185.94±2.19℃ in FM plugger, 169.51±9.12℃ in M plugger, and 160.79±1.27℃ in ML plugger and the peak temperature was highest in F type and followed by, in descending order, FM type, M type. ML type showed the lowest peak temperature (p<0.01). This results suggest that the actual temperature on the surface of the pluggers does not correlate well with the temperature set on digital display. Heat concentrates around the tip. The larger plugger reveals lower temperature rise relatively.

장시간 불가피한 공복(fasting)후 인체의 내분비 변화 : 삼풍백화점 붕괴 사고후 구조된 3인의 증례 THREE CASES IN COLLAPSE OF SAMPOONG DEPARTMENT STORE

박규남,황주일,박조현,오동렬,이원재,오승택,김세경,김인철 대한응급의학회 1995 대한응급의학회지 Vol.6 No.2

The interactions between nutrition and the endocrine system are more intimate and complex that previously thought. Nutrition modulates secretion and activity of many hormones, as part of the stress adaptation process. Fasting, in particular, produces a number of important changes in the endocrine system, with teleological purpose of helping the body tolerate the lack of food ingestion. These changes are therefore beneficial and protective, although at times they may not appear to be that way. The endocrine changes of fasting mediate the metabolic response. We must emphasize that these changes are completely reversible when appropriate nutrition is established. These changes are as followes: 1) decreased insulin and increased glucagon levels, 2) decreased thyroid effect, 3) decreased sympathetic activity, 4) hypothalamic hypogonadism, 5) decreased growth, 6) altered glucocorticoid secretion and metabolism, 7) impaired mineralocorticoid response, 8) decreased ADH secretion and effect. We experienced three cases of involuntary prolonged fasting after collapse of Sampoong department store. They were released from collapsed field after 11(case Ⅰ), 13(case Ⅱ), 17days(case Ⅲ) respectively. In each case, the endocrine changes of plasma levels were as followes: decrease of cortisol in case Ⅰ, increase of GH in case Ⅱ, decrease of free T3, T3, cortisol and increase of reverse T3, insulin in case Ⅲ. Each one did not show the same endocrine changes of plasma levels. But we think these changes of fasting are beneficial in metabolic response of human.

Endoscopy and Imaging Modalities/Basic Science of Gastrointestinal Disorders/Miscellaneous : Changing Pattern Of Digestive And Liver Disease In Korea, 1990-2006 Year; A Single Center Study

( Jung Hyun Kwon ),( Sang Woo Kim ),( In Sik Chung ),( Myung Gyu Choi ),( Kwan Woo Nam ),( Jung Pil Suh ),( Jae Hyuck Chang ),( Won Haing Hur ),( Yu Kyung Cho ),( Jae Myung Park ),( In Seok Lee ) 대한소화기학회 2007 SIDDS Vol.9 No.-

Background/Aims: Westernization in many Asian countries have changed lifestyles and diets, so once rare diseases have now become prevalent. The aim of this study is to investigate the changing pattern of digestive and liver disease in Korea, from 1990 to 2006. Methods: We extracted data specific gastrointestina (GI) disease based on the International Classification of Diseases code from the in-patients records at the Kangnam St. Mary`s Hospital in 1990, 1996 and 2006. This hospital is a tertiary-care hospital in Seoul, Korea, which has a capacity of 800 beds. Results: The admission rate for GI disease increased between 1990 and 2006. Overall in-patients were 1,623 persons in 1990, 2,368 persons in 1996 and 4,166 persons in 2006. The mean age of in-patients increased as time went by. A stomach cancer was the most common diagnosis during all periods, but its prevalence has decreased. Colon cancer ranked the 7th in 1990, but markedly increased and now ranks the second. The third was a hepatocellular carcinoma. The bile duct and gallbladder cancer, pancreas and esophageal cancer ranking followed with little interval change. In cases of cancer patients, a regular admission dramatically increased for chemotherapy. The number of patients admitted with pre-malignant neoplasm of stomach and colon increased remarkably with the development of endoscopy. The liver transplant, inflammatory bowel discase, and reflux esophagitis emerged form mid-1990s with greater frequencies, yet much below the levels found in the West. The admission rate for peptic ulcer, especially ulcer bleeding remained relatively stable, despite a decreased rate for ulcer perforation. Liver cirrhosis, hepatitis, cholelithiasis with cholecystitis-cholangitis, appendicitis, hemorrhoid and gastritis all decreased. Conclusions: The stomach cancer is the leading cause of admission, despite a recent decline. Colon cancer showed a marked rise. The liver transplant, inflammatory bowel disease and reflux esophagitis were new diagnosis with an increased tendency.

S-244 : Long Term Prognostic Value of HbA1C in Acute Myocardial Infarction Patients without Known Diabetes

( Il Hyung Jung ),( Chung Kang ),( Dong In Nam ),( Sang Cheol Cho ),( Wan Kim ),( Myung Ho Jeong ) 대한내과학회 2013 대한내과학회 추계학술대회 Vol.2013 No.1

Background: The prognostic role of glycosylated hemoglobin (HbA1C) in non-diabetic (non-DM) patients with acute myocardial infarction (AMI) is still controversial. We evaluated the prognostic role of HbA1C in AMI patients without previously known diabetes. Methods: From January 2008 to August 2011, 3,292 in AMI patients with non-DM [65.6±13.1 years, 2,460 men (74.8%)] who underwent laboratory testing of HbA1C were enrolled retrospectively. Patients were divided into two groups by HbA1C [Group 1 ≤ 6.5%, n=2,864 (87%); Group 2 > 6.5%, n=428 (13%)]. The primary end point was composite major adverse cardiac events (MACEs) including all cause death, cardiac death, re-MI, and revascularization of target or non-target vessel during 12 months follow up. Results: Patients of in-hospital all cause death and cardiac death were 202 [169 (6.0%) vs. 33 (6.8%), p>0.05) and 145 [124 (4.4%) vs. 21 (4.3%), p>0.05], respectively. BMI (24.0±3.1 vs. 24.9±3.6), blood glucose (145±55 vs. 207±90 mg/dL), total cholesterol (184±44 vs. 196±47 mg/dL), triglyceride (121±88 vs. 157±118 mg/dL), LDL (118±39 vs. 127±41 mg/dL) and hs-CRP (5.35±20.3 vs. 8.76±34.9 mg/dL) were higher and HDL (44.4±14.7 vs. 42.2±11.7 mg/dL) was lower in group 2 (p of all variables < 0.01). The incidence of hyperlipidemia (9.2% vs. 12.4%, p=0.036), obesity (BMI ≥ 30, 3.3% vs. 8.2%, p<0.01), current smoker (44.7% vs. 50.2%, p=0.032), and left ventricular (LV) dysfunction (ejection fraction<40%, 11.3% vs. 15.4%, p=0.021) were more frequent in group 2. There were no significant difference in clinical outcomes at 12 months. In subgroup analysis (group 1 was divided by 5.5% of HbA1C), there were no significant difference in short and long term clinical outcomes. Old Age (age ≥ 65 years), high Killip class (III & IV), LV dysfunction, and renal insufficiency (GFR <60 mL/min) were independent predictors of 12 months composite MACEs. Conclusion: Korean AMI patients with non-DM and HbA1C > 6.5% were not associated with worse outcomes during 12 months follow up.

심인성쇼크로 관상동맥 중재술 중 대동맥 내 풍선펌프 사용 시 임상 경과

이재필 ( Jae Pil Lee ),남창욱 ( Chang Wook Nam ),박정호 ( Jung Ho Park ),배종엽 ( Jong Yop Bae ),김인철 ( In Cheol Kim ),조윤경 ( Yun Kyeong Cho ),박형섭 ( Hyoung Sub Park ),윤혁준 ( Hyuck Jun Yoon ),김형섭 ( Hyungseop Kim ),허승 대한내과학회 2015 대한내과학회지 Vol.89 No.2

Background/Aims: The mortality of hospitalized patients undergoing treatment with an intra-aortic balloon pump (IABP) due to cardiogenic shock is well known as quite high. The aim of this study was to evaluate the outcome of percutaneous coronary intervention (PCI) with an IABP in patients with acute coronary syndrome (ACS) and cardiogenic shock and identify the predictors of in-hospital mortality. Methods: 134 patients who underwent PCI with IABP due to ACS complicated by cardiogenic shock were consecutively enrolled. Outcomes were obtained and analyzed during hospitalization and after 1 year. Results: The incidence of all-cause mortality was 35.8% (in-hospital mortality, 34.3%, 1-year mortality, 1.5%). The nonsurvival group exhibited higher peak levels of creatine kinase MB, lower ejection fractions, and higher incidences of ST elevation myocardial infarction, ventricular arrhythmia, and use of an assistive device than did the survival group. Aging (hazard ratio 2.839, 95% confidence interval 1.408-5.723, p = 0.004), the use of a temporary pacemaker (2.035, 1.114-3.720, 0.021), the use of a mechanical ventilator (4.376, 1.852-10.341, 0.001), and the performance of cardiopulmonary resuscitation (CPR) (2.219, 1.017-4.839, 0.045) were independent predictors for in-hospital mortality. However, out-of-hospital mortality among in-hospital survivors was not affected by predictors of in-hospital mortality. Conclusions: The incidence of in-hospital mortality was high, as expected in patients undergoing PCI with IABP due to ACS with cardiogenic shock. Aging, CPR, and additional procedures such as pacemaker use and mechanical ventilation were predictors of in-hospital mortality. However, the patients who were successfully discharged after the complex procedure showed acceptable 1-year outcomes. (Korean J Med 2015,89:186-191)

Wolff-Parkinson-White증후군의 임상상 및 전기생리학적 소견

안신기,이문형,장양수,오동진,최인석,하종원,임세중,김병옥,정남식,심원흠,조승연,김성순 대한순환기학회 1997 Korean Circulation Journal Vol.27 No.9

다양한 진로모색을 위한 치위생학과 학생과 선배 치과위생사의 심층면담

경혜인 ( Hye In Kyung ),김영우 ( Young Woo Kim ),엄제현 ( Jae Hyun Eom ),이지희 ( Ji Hui Lee ),조은정 ( Eun Jung Cho ),박고은 ( Go Eun Park ),김남희 ( Nam Hee Kim ) 한국치위생과학회 2015 치위생과학회지 Vol.15 No.2

The aim of this study was to provide practical information regarding career exploration to dental hygiene students. This study interviewed 15 senior dental hygienists (graduates of Y University Dental Hygiene program) who have worked in non-clinical fields for about three months from January 14, 2014 to April 28. The most frequently mentioned pieces of information that the senior dental hygienists wanted to convey to dental hygiene students were as followed. Contrary to popular belief, clinical experience was also required in non-clinical fields as the importance of clinical experience was quite often and widely emphasized and applied in such fields. High academic excellence and clinical performance were expected of junior dental hygienists and the senior dental hygienists expressed their hope for their juniors to pioneer new fields and areas of work that a dental hygienist can do. Most of the senior dental hygienists pointed out that to develop technical tools for career exploration as early as possible, such as during undergraduate years and to think about which career path to take, whether it is clinical or academic were significantly important factors for desirable career outcomes. Based on the results of this study, undergraduate dental hygiene students should be provided with opportunities to consider and explore various career paths during their undergraduate years and to communicate with their seniors for hands-on experience-based advices. This would in turn broaden each student`s perspective beyond their knowledge or thought about the professional filed of dental hygiene. It was found that the majority of the senior dental hygienists agreed that their clinical experience was the source of their self-competence as a dental hygienist. Our study could be utilized as a valuable resource for future dental hygienists who wish to work in non-clinical fields.

A hybrid PET-MRI: An integrated molecular-genetic imaging system with HRRT-PET and 7.0-T MRI

Cho, Zang-Hee,Son, Young-Don,Kim, Hang-Keun,Kim, Kyoung-Nam,Oh, Se-Hong,Han, Jae-Yong,Hong, In-Ki,Kim, Young-Bo JOHN WILEY & SONS LTD 2007 INTERNATIONAL JOURNAL OF IMAGING SYSTEMS AND TECHN Vol.17 No.4

<P>A PET-MRI fusion system is developed for molecular-genetic imaging. The purpose of the system is to obtain images of the in-vivo human brain using two high-end imaging devices, an advanced PET and an ultrahigh-field MRI. These are the HRRT-PET, a high-resolution research tomograph dedicated to brain imaging on the molecular level, and the 7.0-T MRI, an ultrahigh field version used for morphological imaging. HRRT-PET delivers high-resolution molecular imaging with a resolution down to 2.5 mm FWHM, which is currently the highest spatial resolution available for the observation of the human brain's molecular activities, including enzymes and receptors, which are manipulated genetically, such as reporter genes and probes. The 7.0-T MRI began to reveal submillimeter resolution images of the cortical as well as deep brain areas, down to 250 μm, which allows us to visualize the fine details of the cortical and brainstem areas, including the line of Gennari in the visual cortex and the corticospinal tracts in the pontine area. The current PET-MRI fusion imaging system produces the highest quality images of molecular and genetic activities of the human brain in vivo. It is starting to provide many answers to the key questions about the neurological diseases. Some of these start providing answers to many cognitive neuroscience problems with clear molecular and genetic bases. There is great potential in the PET-MRI for early diagnosis of cancers as well as other neurological diseases, which we were previously unable to diagnose, such as microscopic molecular changes that occur in Parkinson's and Alzheimer's diseases. © 2007 Wiley Periodicals, Inc. Int J Imaging Syst Technol, 17, 252–265, 2007</P>

The Identification of Binding Mode for Arabidopsis thaliana 7-Keto-8-aminopelargonic Acid Synthase (AtKAPAS) Inhibitors

Cho, Jae-Eun,Kang, Sun-Young,Choi, Jung-Sup,Ko, Young-Kwan,Hwang, In-Taek,Kang, Nam-Sook Korean Chemical Society 2012 Bulletin of the Korean Chemical Society Vol.33 No.5

In this study, we determined the 3D-structure of Arabidopsis thaliana KAPAS by homology modeling. We then investigated the binding mode of compounds obtained from in-house library using computational docking methods. From the flexible docking study, we achieved high dock scores for the active compounds denoted in this study as compound $\mathbf{3}$ and compound $\mathbf{4}$. Thus, we highlight the flexibility of specific residues, Lys 312 and Phe 172, when used in active sites.