PURPOSE: The aim of this study was to evaluate the effectiveness of our retraction method for achieving a good operative field for the adequate lymph node dissection during laparoscopic gastrectomy in view of short term surgical outcome. MATERIALS AND METHODS: This study prospectively enrolled 19 patients who underwent laparoscopic gastrectomy for early gastric cancer. The procedure was simply performed by putting the laparoscopic sigle suture in the phrenoesophageal ligament, and then the string was pulling and tying over the sternum. Surgical outcomes of these patients were evaluated. RESULTS: Under V-shaped liver retraction, the mean operating time and mean number of retrieved lymph nodes was 166.3 minute and 31.37, respectively. And the results were satisfactory compared to open or conventional laparoscopic gastric surgery. CONCLUSIONS: V-shaped liver retraction requires no extra port or assistant's hands, and prevents additional injury to any intra-abdominal organ. And this method can easily, efficiently and safely enable to achieve a good operative field for the lymph node dissection near the lesser curvature of the stomach.
Gastrectomy ; Hand ; Humans ; Laparoscopy ; Ligaments ; Liver ; Lymph Node Excision ; Lymph Nodes ; Prospective Studies ; Sternum ; Stomach ; Stomach Neoplasms ; Sutures

The purpose of this study has been performed to investigate the possibility of external audit program using thermoluminescence dosimetry for electron beam in korea. The TLD system consists of LiF powder, type TLD-700 read with a PCL 3 reader. In order to determine a calibration coefficient of the TLD system, the reference dosimeters are irradiated to 2 Gy in a (60)Co beam at the KFDA The irradiation is performed under reference conditions is water phantom using the IAEA standard holder for TLD of electron beam. The energy correction factor is determined for LiF powder irradiated of dose to water 2 Gy in electron beams of 6, 9, 12, 16 and 20 MeV (Varian CL 2100C). The dose is determined according to the IAEA TRS-398 and by measurement with a PTW Roos type plane-parallel chamber. The TLD for each electron energy are positioned in water at reference depth. In this study, to verify of the accuracy of dose determination by the TLD system are performed through a 'blind' TLD irradiation. The results of blind test are 2.98%, 3.39% and 0.01% (1sigma) at 9, 16, 20 MeV, respectively. The value generally agrees within the acceptance level of 5% for electron beam. The results of this study prove the possibility of the TLD quality assurance program for electron beams. It has contributed to the improvement of clinical electron dosimetry in radiotherapy centers.
Calibration ; Fibrinogen ; Korea ; Radiotherapy ; Water

BACKGROUND/AIMS: Endoscopic submucosal dissection (ESD) allows removal of colorectal epithelial neoplasms en bloc regardless of size. Colorectal ESD is a difficult procedure because of technical difficulties and risks of complications. This study aimed to assess the relationship between ESD outcome and degree of submucosal fibrosis. METHODS: Patients with colorectal tumors undergoing ESD and their medical records were reviewed retrospectively. The degree of submucosal fibrosis was classified into three types. The relationship between ESD outcome and degree of submucosal fibrosis was analyzed. RESULTS: ESD was performed in 158 patients. Thirty-eight cases of F0 (no) fibrosis (24.1%) and 46 cases of F2 (severe) fibrosis (29.1%) were observed. Complete resection was achieved for 138 lesions (87.3%). Multivariate analysis demonstrated that submucosal invasion of tumor and histology of carcinoma were independent risk factors for F2 fibrosis. Severe fibrosis was an independent risk factor for incomplete resection. CONCLUSIONS: Severe fibrosis is an important factor related to incomplete resection during colorectal ESD. In cases of severe fibrosis, the rate of complete resection was low even when ESD was performed by an experienced operator. Evaluation of submucosal fibrosis may be helpful to predict the submucosal invasion of tumors and technical difficulties in ESD.
Colorectal Neoplasms ; Fibrosis* ; Humans ; Medical Records ; Multivariate Analysis ; Neoplasms, Glandular and Epithelial ; Retrospective Studies ; Risk Factors

BACKGROUND/AIMS: Endoscopic submucosal dissection (ESD) allows removal of colorectal epithelial neoplasms en bloc regardless of size. Colorectal ESD is a difficult procedure because of technical difficulties and risks of complications. This study aimed to assess the relationship between ESD outcome and degree of submucosal fibrosis. METHODS: Patients with colorectal tumors undergoing ESD and their medical records were reviewed retrospectively. The degree of submucosal fibrosis was classified into three types. The relationship between ESD outcome and degree of submucosal fibrosis was analyzed. RESULTS: ESD was performed in 158 patients. Thirty-eight cases of F0 (no) fibrosis (24.1%) and 46 cases of F2 (severe) fibrosis (29.1%) were observed. Complete resection was achieved for 138 lesions (87.3%). Multivariate analysis demonstrated that submucosal invasion of tumor and histology of carcinoma were independent risk factors for F2 fibrosis. Severe fibrosis was an independent risk factor for incomplete resection. CONCLUSIONS: Severe fibrosis is an important factor related to incomplete resection during colorectal ESD. In cases of severe fibrosis, the rate of complete resection was low even when ESD was performed by an experienced operator. Evaluation of submucosal fibrosis may be helpful to predict the submucosal invasion of tumors and technical difficulties in ESD.
Colorectal Neoplasms ; Fibrosis* ; Humans ; Medical Records ; Multivariate Analysis ; Neoplasms, Glandular and Epithelial ; Retrospective Studies ; Risk Factors

No abstract available.
Purpura* ; Thrombocytopenia*

BACKGROUND: The metabolic syndrome (MS) is a cluster of risk factors of cardiovascular disease. The association between components of the MS and bone mineral density has been researched, but no prior studies have directly evaluated the association with the metabolic syndrome and bone mineral density in Korea. METHODS: We evaluated postmenopausal women who had visited a university hospital from November 2006 to October 2007. Data on their lifestyle, current medical diseases and medications were collected from medical records. Height, body weight, waist circumference and serum lipid profiles were measured. RESULTS: The prevalence of metabolic syndrome was 21.8% in this study. In adjusted analysis including age and other factors, only waist circumference had a close correlation with bone mineral density of femur and lumbar vertebral body (P < 0.05). The bone mineral density of femur and lumbar vertebral body had no correlation with the presence of metabolic syndrome. When stratified by body mass index, corrected bone mineral density revealed no significant correlation with the presence of metabolic syndrome. CONCLUSION: The bone mineral density of postmenopausal women with metabolic syndrome has highly influenced by obesity, especially by abdominal obesity.
Body Height ; Body Mass Index ; Bone Density ; Cardiovascular Diseases ; Female ; Femur ; Humans ; Life Style ; Medical Records ; Obesity ; Obesity, Abdominal ; Osteoporosis ; Prevalence ; Risk Factors ; Waist Circumference

BACKGROUND: The metabolic syndrome (MS) is a cluster of risk factors of cardiovascular disease. The association between components of the MS and bone mineral density has been researched, but no prior studies have directly evaluated the association with the metabolic syndrome and bone mineral density in Korea. METHODS: We evaluated postmenopausal women who had visited a university hospital from November 2006 to October 2007. Data on their lifestyle, current medical diseases and medications were collected from medical records. Height, body weight, waist circumference and serum lipid profiles were measured. RESULTS: The prevalence of metabolic syndrome was 21.8% in this study. In adjusted analysis including age and other factors, only waist circumference had a close correlation with bone mineral density of femur and lumbar vertebral body (P < 0.05). The bone mineral density of femur and lumbar vertebral body had no correlation with the presence of metabolic syndrome. When stratified by body mass index, corrected bone mineral density revealed no significant correlation with the presence of metabolic syndrome. CONCLUSION: The bone mineral density of postmenopausal women with metabolic syndrome has highly influenced by obesity, especially by abdominal obesity.
Body Height ; Body Mass Index ; Bone Density ; Cardiovascular Diseases ; Female ; Femur ; Humans ; Life Style ; Medical Records ; Obesity ; Obesity, Abdominal ; Osteoporosis ; Prevalence ; Risk Factors ; Waist Circumference

Monte Carlo calculations were performed to demonstrate the dose modulation with dynamic magnetic fields in phantom. The goal of this study is to obtain the uniform dose distributions at a depth region as a target on the central axis of photon beam under moving transverse magnetic field. We have calculated the depth dose curves for two cases of moving magnetic field along a depth line, constant speed and optimal speed. We introduced step-by-step shift and time factor of the position of the electromagnet as an approximations of continuous moving. The optimal time factors as a function of magnetic field position were calculated by least square methods using depth dose data for static magnetic field. We have verified that the flat depth dose is produced by varying the speed of magnetic field as a function of position as a results of Monte Carlo calculations. For 3 T magnetic field, the dose enhancement was 10.1% in comparison to without magnetic field at the center of the target.
Axis, Cervical Vertebra ; Magnetic Fields* ; Magnets ; Time Factors

In this work we have measured the dose distribution and the percent depth dose of 20 MeV electron beam using the X-OMAT films in order to verify the effects of transverse magnetic field on high energy elecrtron beam in a phantom. The result shows about 30% increase of the percent depth dose at 4.5 cm depth under the transverse magnetic field of 1.5 Tesla at 7.5 cm depth. We have verified that these were in an agreement with other theoretical results.
Magnetic Fields*

Gerbil has no Willis circle so we can make the model of cerebral ischemia simply by occluding the common carotid artery. In this study, we occluded the common carotid arteries of the gerbil for 5 minutes, and at the designated reperfusion time (0.5, 3, 6, 12 and 24 hrs), the experimental animals were killed for histopathological and neurofilament 68 kDa immunohistochemical study. At 12 hrs after ischemia the neuronal cell change occurred in inner nuclear layer (INL)and ganglion cell layer (GCL). At 24 hrs after ischemia the disappearance of neurons were observed in GCL and severe edema, pyknotic degeneration were observed in INL and outer nuclear layer (ONL ). On immunohistochemical study, the NF 68 kDa antibody labelled the cell bodies in the GCL and some nerve fibers in nerve fiber layer (NFL). In addition, the processes of horizontal cells also showed the slight NF 68 kDa immunoreactivity. After ischemic insult, the intensity of NF 68 kDa immunoreactivity in GCL and NFL was slightly decreased. But, its intensity in the process of horizontal cells was increased. And the NF 68 kDa immunoreacticity was detected in some neurons of INL and ONL. This represents the neurofilament protein has the important role in the cell death at the ischemic retina as well as at the ischemic brain.
Animals ; Brain ; Brain Ischemia ; Carotid Artery, Common ; Cell Death ; Circle of Willis ; Edema ; Ganglion Cysts ; Gerbillinae* ; Ischemia ; Nerve Fibers ; Neurons ; Reperfusion ; Retina*