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An, Ji Yeong,Min, Jae Seok,Lee, Young Joon,Jeong, Sang Ho,Hur, Hoon,Han, Sang Uk,Hyung, Woo Jin,Cho, Gyu Seok,Jeong, Gui Ae,Jeong, Oh,Park, Young Kyu,Jung, Mi Ran,Park, Ji Yeon,Kim, Young Woo,Yoon, Ho Hindawi 2017 Gastroenterology Research and Practice Vol.2017 No.-
<P><B>Background</B></P><P> We investigated the results of quality control study prior to phase III trial of sentinel lymph node navigation surgery (SNNS). </P><P><B>Methods</B></P><P> Data were reviewed from 108 patients enrolled in the feasibility study of laparoscopic sentinel basin dissection (SBD) in gastric cancer. Seven steps contain tracer injection at submucosa (step 1) and at four sites (step 2) by intraoperative esophagogastroduodenoscopy (EGD), leakage of tracer (step 3), injection within 3 minutes (step 4), identification of at least one sentinel basin (SB) (step 5), evaluation of sentinel basin nodes (SBNs) by frozen biopsy (step 6), and identification of at least five SBNs at back table and frozen sections (step 7). </P><P><B>Results</B></P><P> Failure in step 7 (<I>n</I> = 23) was the most common followed by step 3 (<I>n</I> = 15) and step 6 (<I>n</I> = 13). We did not find any differences of clinicopathological factors between success and failure group in steps 1~6. In step 7, body mass index (BMI) was only the significant factor. The success rate was 97.1% in patients with BMI < 23 kg/m<SUP>2</SUP> and 80.3% in those with BMI ≥ 23 kg/m<SUP>2</SUP> (<I>P</I> = 0.028). </P><P><B>Conclusions</B></P><P> Lower BMI group showed higher success rate in step 7. Surgeons doing SNNS should be cautious when evaluating sufficient number of SBN in obese patients.</P>
An, Ji Yeong,Min, Jae Seok,Lee, Young Joon,Jeong, Sang Ho,Hur, Hoon,Han, Sang Uk,Hyung, Woo Jin,Cho, Gyu Seok,Jeong, Gui Ae,Jeong, Oh,Park, Young Kyu,Jung, Mi Ran,Park, Ji Yeon,Kim, Young Woo,Yoon, Ho The Korean Gastric Cancer Association 2018 Journal of gastric cancer Vol.18 No.1
Purpose: We investigated complications after laparoscopic sentinel basin dissection (SBD) for patients with gastric cancer who were enrolled in a quality control study, prior to the phase III trial of sentinel lymph node navigation surgery (SNNS). Materials and Methods: We analyzed prospective data from a Korean multicenter prerequisite quality control trial of laparoscopic SBD for gastric cancer and assessed procedure-related and surgical complications. All complications were classified according to the Clavien-Dindo Classification (CDC) system and were compared with the results of the previously published SNNS trial. Results: Among the 108 eligible patients who were enrolled in the quality control trial, 8 (7.4%) experienced complications during the early postoperative period. One patient with gastric resection-related duodenal stump leakage recovered after percutaneous drainage (grade IIIa in CDC). The other postoperative complications were mild and patients recovered with supportive care. No complications were directly related to the laparoscopic SBD procedure or tracer usage, and there were no mortalities. The laparoscopic SBD complication rates and patterns that were observed in this study were comparable to those of a previously reported trial. Conclusions: The results of our prospective, multicenter quality control trial demonstrate that laparoscopic SBD is a safe procedure during SNNS for gastric cancer.
장애인 생활안정 지원제도 개선방안 연구 - 공공시설 내 장애인 매점·자판기 우선허가제도-
김경란(Kim Kyoung Ran),권오형(Kwon Oh Hyeong),박주영(Park Ju Yeong) 한국직업재활학회 2008 職業再活硏究 Vol.18 No.1
본 연구는 장애인의 생활안정지원을 취지로 공공시설 내 장애인 매점ㆍ자판기 우선허가제도와 관련하여 국내ㆍ외 관련 법률, 운영현황, 전달체계를 분석하고, 실태조사를 통하여 실질적으로 장애인들에게 생활안정과 자립에 기여할 수 있는 개선방안을 마련하는 것을 목적으로 하였다. 이를 위하여 현재 공공기관에서 장애인우선허가를 부여받아 운영하고 있는 전국의 장애인(322명)과 공무원(127명)를 대상으로 인지경로 및 공고방법, 운영현황, 생활안정 도움정도, 수익금 정도, 문제점, 개선사항 등에 대한 전화면접조사를 실시하여 자료를 수집하였다. 조사결과, 장애인들은 생활안정 도움정도에 대해서는 47.5%가 도움이 되지 않는다고 응답하였다. 평균 월 수익금은 25만8천원이며, 위탁 운영할 경우 수익금이 현저히 낮게 나타났다. 우선허가제도에 대한 장애인들의 개선사항은 소득/수익개선에 대한 요구가 가장 많은 반면, 공무원은 운영/관리에 대한 교육강화가 가장 시급한 것으로 조사되었다. 이를 바탕으로 첫째, 장애인복지법상의 임의규정을 강제규정으로 전환, 조례강화, 둘째, 수익구조 측면에서는 판매아이템 개발 및 품목확대, 개인 수량확대 셋째, 관리운영측면에서는 기존의 해당기관에서 관리하는 체계를 직업재활실시기관에서 위탁운영하여 물품수급, 및 회계관리 등의 근로지원과 중증장애인의 경우 활동보조인을 지원함으로써 장애인 스스로 자립하여 운영하는 것을 제안한다. The purpose of this study is to improve the supporting system for the stabilization and independent living and increase their incomes for the disabled to analyze the law and operational situation and delivery system of priority grant system in domestic and foreign countries. For this, the data was collected by interviewing the 322 disabled persons who operate vending machines and stands and 127 public officials managing the priority of them in the public facilities in terms of the managerial condition and stabilization and income structure and its improvement of this system. This study revealed that 47.5%operators with disabilities do not stabilize their livelihood through operating the vending machines and stands which they earn averagely 258,000won from them. in case of consignment management, it is revealed that its income has been reduced much. The study also found that the improvement of this system is to develop the low income structure for the disabled. Meanwhile, for the public officials, the education of the management of it should be strengthen first. Therefore, the study proposed that first of all, ordinance of this provision of this system should be reinforced intensively and be required by revising arbitrary provision into compulsory one of Disability Welfare Act. Secondly, the low benefits from the business should be boosted throughout the development and expansion of the scope of new items, and increase of quantity of vending machine and stand. Thirdly, management by the vocational rehabilitation facilities which can be supported goods supply and account arrange instead of persons with disabilities would be suggested. If necessary, it is a good alternative that personal assistance service will be aided for severe disabilities for the purpose of the stabilization and independent living.