188Re (beta=22 MeV; gamma=155 keV; T1/2=16.9 hours) is an attractive therapeutic radioisotope which is produced from decay of reactor-produced tungsten-188 parent (T1/2=69 days). 188W has been produced from the double neutron capture reaction of 186W. 188Re can be easily obtained by elution of saline on alumina based 186W/188Re generator, which is commercially available. Complexes labelled with 188Re have been developed for the radiotherapy treatment of diseases because of the desirable nuclear properties of the radioisotope and it's chemical properties similar to those of technetium, a well established diagnostic agent.
Aluminum Oxide ; Humans ; Neutrons ; Parents ; Radiotherapy ; Technetium

In hypertensive patients it is very important to detect renal artery stenosis or pheochromocytoma, since both diseases are curable causes of hypertension. However, renal artery stenosis can be induced by pheochromocytoma, when the diagnosis of the two simultaneous disease is very difficult. We experienced two cases of pheochromocytoma presented as renal artery stenosis. Pheochromcytoma was overlooked when renovascular hypertension was diagnosed. Pheochromocytoma was found during surgery in one patient and after angioplasty in the other. In both cases, BP returned to normal after surgical removal of pheochromocytoma without repair of the stenosis. Prevention of ineffective and unnecessary renal artery angioplasty of surgery requires knowledge of this unusal association between pheochromocytoma and renal artery stenosis and a high degree of clinical alertness for pheochromocytoma.
Angioplasty ; Constriction, Pathologic ; Diagnosis ; Humans ; Hypertension ; Hypertension, Renovascular ; Pheochromocytoma* ; Renal Artery Obstruction* ; Renal Artery*

PURPOSE: The clinical significance of preoperative serum levels of CEA and CA19-9, levels of CEA and CA19-9 in peritoneal washing fluid and free cancer cells in peritoneal washing fluid in gastric cancer patients were evaluated in this study. MATERIALS AND METHODS: Serum and peritoneal levels of CEA and CA19-9 and peritoneal washing cytology in 115 patients with gastric cancer were analyzed with respect to the prognostic factors using univariate and multivariate analysis. RESULTS: Positive rate of serum CEA and CA19-9 was 16.5%, 13.0%. And that of peritoneal washing CEA, CA19-9 and cytology was 15.7%, 7.8% and 9.6%. A univariate analysis showed that tumor markets in serum and peritoneal washing fluid and peritoneal washing cytology had significant correlations with the progression of the tumors, and patients with positive serum or peritoneal tumor markers had poorer survival after operation than did the patients with negative tumor markers. But in a multivariate analysis showed that only peritoneal CA19-9 was an independent risk factor. And combination of these five markers provided rnore predictable prognostic informations in a multivariate analysis. CONCLUSION: Combination of serum or peritoneal levels of CEA, CA19-9 and washing cytology appeared to be a useful marker for managing gastric cancer patients.
Humans ; Multivariate Analysis ; Risk Factors ; Stomach Neoplasms ; Biomarkers, Tumor

No abstract available.
Intensive Care Units ; Sepsis ; Critical Illness ; Chronic Disease ; Hospital Mortality

BACKGROUND: Aging is a significant issue worldwide, and Korea is one of the most rapidly aging countries. Along with the demographic transition, the age structure of intensive care unit (ICU) patients changes as well. METHODS: The aim of this study was to analyze the change in age distribution of the ICU patients over the last 10 years and its effect on clinical outcomes. Single-center, retrospective analysis of all patients aged ≥18 years admitted to either the medical or surgical ICU at St. Paul's Hospital, The Catholic University of Korea, between January 2005 and December 2014 was conducted. For clinical outcome, in-hospital mortality, duration of ICU stay, and hospital stay were analyzed. Cost analysis was performed to show the economic burden of each age strata. RESULTS: A total of 10,366 ICU patients were admitted to the chosen ICUs during the study period. The proportion of elderly patients aged ≥65 years increased from 47.9% in 2005 to 63.7% in 2014, and the proportion of the very elderly patients aged ≥80 years increased from 12.8% to 20.7%. However, this increased proportion of elderly patients did not lead to increased in-hospital mortality. The percent of ICU treatment days attributable to elderly patients increased from 51.1% in year 2005 to 64.0% in 2014. The elderly ICU patients were associated with higher in-hospital mortality compared to younger age groups. CONCLUSIONS: The proportion of elderly patients admitted to ICUs increased over the last decade. However, overall in-hospital mortality has not increased during the same period.
Age Distribution ; Aged* ; Aging ; Costs and Cost Analysis ; Critical Care* ; Hospital Mortality ; Humans ; Intensive Care Units* ; Korea* ; Length of Stay ; Mortality ; Population Dynamics ; Retrospective Studies*

Situs inversus totalis is a congenital condition in which there is complete right to left reversal of the thoracic and abdominal organ. According to an increase in minimally invasive treatments, laparoscopic surgery for patients with situs inversus totalis has also been increasing. We performed laparoscopy-assisted subtotal gastrectomy on a 60-year-old gastric cancer patient with situs inversus totalis. He was diagnosed with early stage gastric adenocarcinoma at antrum of the anterior wall. We experienced some technical difficulties because of the position and anatomic variation of major vessels. However, the subtotal gastrectomy was completed with D1+ beta lymph node dissection followed by extracorporeal gastroduodenostomy. The patient was discharged six days after operation without any complications. The pathologic report showed that tumor invasion was limited to the submucosa and one lymph node was positive for metastasis. We believe our experience is the first reported case of laparoscopic gastric cancer surgery for situs inversus in Korea.
Adenocarcinoma ; Anatomic Variation ; Gastrectomy ; Humans ; Korea ; Laparoscopy ; Lymph Node Excision ; Lymph Nodes ; Middle Aged ; Neoplasm Metastasis ; Situs Inversus ; Stomach Neoplasms

PURPOSE: Peritoneal recurrence has been reported to be the most common form of recurrence of gastric cancer. Peritoneal recurrence can generally be suggested by several types of image studies and also if there is evidence of ascites or Bloomer's rectal shelf. It can be confirmed by explorative laparotomy, but diagnostic laparoscopy is a good alternative method and laparoscopic surgery has also been widely used. We reviewed and analyzed the ability of diagnostic laparoscopy to detect peritoneal recurrence or carcinomatosis, and especially for gastric cancer. MATERIALS AND METHODS: We performed a retrospective review the 45 gastric cancer patients who were operated via diagnostic laparoscopy between 2004. 2. and 2009. 3. We analyzed the perioperative clinical characteristics and the accuracy of the diagnostic methods. RESULTS: The study groups included 14 patients who had confirmed gastric cancer, but they suspected to have carcinomatosis, and 31 patients who had previously underwent gastric resection, but they suspected to have recurrence. The mean operation time was 44.1+/-6.9 minutes and the mean postoperative hospital stay was 2.7+/-.8 days. There was one case of operation-related complication and no postoperative mortality occurred. The sensitivities for detecting peritoneal recurrence or carcinomatosis were 92.1% for diagnostic laparoscopy, 29.7% for detecting ascites and rectal shelf on the physical examination, 86.5% for abdominal computed tomography, 69.2% for PET CT and 18.8% for CEA. CONCLUSION: Diagnostic laparoscopy does not require a long operation time or a long hospital stay, and it showed a low complication rate in our study. It has high sensitivity for detecting peritoneal recurrence of gastric cancer. It can be an alternative diagnostic confirmative method and it is useful for deciding on further treatment.
Ascites ; Carcinoma ; Humans ; Laparoscopy ; Laparotomy ; Length of Stay ; Physical Examination ; Recurrence ; Retrospective Studies ; Stomach Neoplasms

PURPOSE: Laparoscopic gastrectomy has been common treatment modality for gastric cancer. But, most surgeons tend to perform laparoscopy-assisted distal gastrectomy using epigastric incision. Delta-shaped anastomosis is known as intracorporeal gastroduodenostomy, but it is technically difficult and needed many staplers. So we tried to find simple and economical method, here we report on the results of liner-shaped gastroduodenostomy in totally laparoscopic distal gastrectomy. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 25 patients who underwent totally laparoscopic distal gastrectomy using liner-shaped anastomosis at School of Medicine, Ajou University between January to October 2009. The indication was early gastric cancer as diagnosed by preoperative workup, the anastomoses were performed by using laparoscopic linear stapler. RESULTS: There were 12 female and 13 male patients with a mean age of 55.6+/-11.2. The following procedures were performed 14 laparoscopic gastrectomies, 11 robotic gastrectomies. The mean operation time was 179.5+/-27.4 minutes, the mean anastomotic time was 17.5+/-3.4 minutes. The mean number of stapler cartridges was 5.6+/-0.8. Postoperative complication occurred in one patient, anastomotic stenosis, and the patient required reoperation to gastrojejunostomy. The mean length of postoperative hospital stay was 6.7+/-1.0 days except the complication case, and there was no case of conversion to open procedure and postoperative mortality. CONCLUSIONS: Linear-shaped gastroduodenostomy in totally laparoscopic distal gastrectomy is technically simple and feasible method.
Constriction, Pathologic ; Female ; Gastrectomy ; Gastric Bypass ; Gastroenterostomy ; Humans ; Length of Stay ; Male ; Medical Records ; Postoperative Complications ; Reoperation ; Retrospective Studies ; Stomach Neoplasms

Background: Lead, which is widely used in various industrial settings, is a major health hazard for manufacturing workers. Therefore, control of lead exposure has been implemented in an effort to prevent lead-related health problems. In this study, our aim was to evaluate temporal trends in occupational lead exposure in Korean lead workers using data from monitoring of workplace exposure. Methods: A nationwide work environment monitoring database, data from a work environment monitoring institution, and data extracted from a review paper were utilized. Different versions of standard industrial classification codes were aligned with the 10th Korean Standard Industrial Classification, which is generally consistent with the 4th revision of the International Standard Industrial Classification. The multiple data sources were combined and temporal trends over the period from 1994–2021 were estimated. In addition, separate estimation of temporal trends in the storage battery manufacturing industry over the period from 1987–2021 was also performed. Results: A total of 444,296 personal airborne lead measurements were used for the estimation process. The temporal trends in occupational exposure to lead declined by −6% annually over the study period. In particular, levels of lead exposure in the storage battery manufacturing industry showed a steeper decline of −12% annually. Conclusions Findings of our study showed that occupational exposure to lead declined over the period from 1994 to 2021 in Korea. However, adverse effects of exposure to lead on health should be regarded with caution. The results will be useful in conduct of epidemiological studies examining lead-related effects on health.

PURPOSE: Laparoscopic gastric resection (LGR) is increasingly being used instead of open gastric resection (OGR) as the standard surgical treatment for gastric submucosal tumors. Yet there are few reports on which technique shows better postoperative outcomes. This study was performed to compare these two treatment modalities for gastric submucosal tumors by evaluating the postoperative outcomes. We also provide an analysis of the learning curve for LGR. MATERIALS AND METHODS: Between 2003.4 and 2008.8, 103 patients with a gastric submucosal tumor underwent either LGR (N=78) or OGR (n=25). A retrospective review was performed on a prospectively obtained database of 103 patients. We reviewed the data with regard to the operative time, the blood loss during the operation, the time to the first soft diet, the postoperative hospital stay, the tumor size and the tumor location. RESULTS: The clinicopatholgic and tumor characteristics of the patients were similar for both groups. There was no open conversion in the LGR group. The mean operation time and the bleeding loss were not different between the LGR group and the OWR group. The time to first soft diet (3.27 vs. 6.16 days, P<0.001) and the length of the postoperative hospital stay (7.37 vs. 8.88 days, P=0.002) were shorter in the LGR group compared to the OGR group. The tumor size was bigger in the OGR group than that in the LGR group (6.44 vs. 3.65 cm, P<0.001). When performing laparoscopic gastric resection of gastric SMT, the surgeon was able to decrease the operation time and bleeding loss with gaining more experience. We separated the total cases into 3 periods to compare the operation time, the bleeding losses and the complications. The third period showed the shortest operation time, the least bleeding loss and the fewest complications. CONCLUSION: LGR for treating a gastric submucosal tumor was superior to OGR in terms of the postoperative outcomes. An operator needs some experience to perform a complete laparoscopic gastric resection. Laparoscopic resection could be considered the first-line treatment for gastric submucosal tumors.
Diet ; Hemorrhage ; Humans ; Laparoscopy ; Learning Curve ; Length of Stay ; Operative Time ; Prospective Studies ; Retrospective Studies